Computer programming: quality and safety for neonatal parenteral nutrition orders

Area of Science:

• Neonatal Medicine
• Clinical Nutrition
• Health Informatics

Background:

• Parenteral nutrition (PN) ordering requires precision to minimize errors and ensure adequate nutrient delivery.
• Computerized systems offer a potential solution for improving consistency and accuracy in PN orders.
• Evaluating the impact of such systems is crucial for optimizing neonatal care.

Purpose of the Study:

• To assess the effectiveness of a computerized neonatal PN calculator in reducing ordering errors.
• To determine if the calculator optimized nutrient intake, specifically calcium and amino acids (AA).
• To evaluate the impact on caloric, protein, and phosphorus delivery.

Main Methods:

• Retrospective analysis of infants requiring PN during the first 2-3 weeks of life.
• Comparison of PN ordering data from before (2007) and after (2009) calculator implementation.
• Categorization of infants by birth weight (≤1000 g, 1001-1500 g, >1500 g) for analysis.

Main Results:

• Ordering errors decreased significantly from 4.6 to 0.1 per 100 orders post-implementation.
• Calcium intake increased in infants ≤1000 g and >1500 g (P < .001).
• Mean protein intake improved to 97%-99% of goal for lower birth weight groups in 2009, compared to 87% in 2007.

Conclusions:

• Computerized PN ordering systems enhance the quality and safety of neonatal PN orders.
• The calculator effectively optimized calcium and AA intake while minimizing ordering errors.
• This technology represents a valuable tool for improving neonatal nutritional support.