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Long-term home parenteral nutrition: it takes an interdisciplinary approach
Marion Winkler1, Peggi Guenter
1Alpert Medical School, Brown University, Providence, Rhode Island (Dr Winkler); Rhode Island Hospital, Providence, Rhode Island (Dr Winkler); American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) (Dr Winkler, Dr Guenter); Oley Foundation (Drs Winkler and Guenter); Journal of Parenteral and Enteral Nutrition and Topics in Clinical Nutrition (Dr Winkler). Marion F. Winkler, PhD, RD, LDN, CNSC, FASPEN, is an associate professor at the Alpert Medical School of Brown University in Providence, Rhode Island. She practices as the surgical nutrition specialist in the Department of Surgery and Nutritional Support Service at Rhode Island Hospital in Providence, Rhode Island, and has more than 30 years' experience in nutrition support. Dr. Winkler's current research focuses on the quality of life of home parenteral nutrition dependent patients. Peggi Guenter, PhD, RN, is the senior director of Clinical Practice, Advocacy, and Research Affairs at the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) in Silver Spring, Maryland, where she oversees the development of standards, guidelines, and safe practices for nutrition support, advocacy efforts for professionals and patients, and research initiatives for the Society.
Abstract:
Home parenteral nutrition (HPN) is indicated for adults and children who cannot digest and absorb food and who are able to receive therapy safely outside of a hospital. How successful this therapy is depends on the patient's support system and ability to learn and independently administer medically complex procedures. Transition to home is facilitated by identifying all necessary therapies, obtaining information to demonstrate medical necessity, establishing central venous access, reaching goal infusion rate, identifying who will write HPN orders, and coordinating care among all home care providers. An interdisciplinary team provides the most successful process to ensure safe HPN.
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