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Treatment-related problems in neonates receiving parenteral nutrition: risk factors and implications for practice
Amal Akour1,2, Lobna Gharaibeh3, Omar El Khatib4
1Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE. aakour@uaeu.ac.ae.
Insights
Treatment-related problems (TRPs) in neonatal parenteral nutrition (PN) often stem from medication monitoring and dosing issues. Addressing these pharmacotherapy factors is key to preventing complications in neonates receiving PN.
Area of Science:
- Neonatal care
- Clinical pharmacy
- Parenteral nutrition
Background:
- Parenteral nutrition (PN) is critical for neonates but can lead to treatment-related problems (TRPs).
- Understanding TRPs and their contributing factors is essential for preventing adverse outcomes in neonatal patients.
Purpose of the Study:
- To assess the factors influencing treatment-related problems (TRPs) in neonatal patients receiving parenteral nutrition (PN).
Main Methods:
- A retrospective chart review was conducted on 96 neonates receiving PN.
- Data collected included demographics, laboratory results, and TRPs related to PN and pharmacotherapy.
Main Results:
- The most common pharmacotherapy-related TRPs were lack of monitoring (34.2%) and low dosing (17.5%).
- A third of patients had mismatches between nutritional needs and PN composition.
- A positive correlation was found between the number of medications and TRPs (r=0.275, p<0.01; r=0.532, p<0.001).
Conclusions:
- TRPs in neonatal PN are frequent, primarily linked to pharmacotherapy issues like monitoring and dosing.
- Identifying risk factors for TRPs highlights the importance of clinical pharmacists in preventive strategies.
Objectives:
Parenteral nutrition (PN) can be associated with several treatment-related problems (TRPs) and complications in neonatal settings. Thus, understanding the extent and type of these problems and related factors is pivotal to prevent negative consequences of these preparations. Thus, the aim of this study is to assess factors affecting TRPs in neonatal patients receiving PN.
Methods:
This was a retrospective chart review of neonates receiving PN in NICU and other wards. We collected their demographics, and laboratory workup. TRPs related to PN preparations as well as their pharmacotherapy were the primary outcomes.
Results:
Medical charts of 96 neonate were reviewed. The most encountered TRPs related to patients' pharmacotherapy were the lack of frequent monitoring (34.2%) and low dose (17.5%). For PN-related TPRs, a mismatch between patients' nutritional needs and PN composition was observed in third of the patients. Statistically significant positive correlations between number of medications during hospital stay and number of reported TRPs [(r = 0.275, p < 0.01) and (r = 0.532, p < 0.001)] were observed.
Conclusion:
In neonates who receive parenteral nutrition (PN), TRPs are often observed. These problems primarily arise from issues in patients' pharmacotherapy, namely monitoring and dosing. Identifying the risk factors for these TRPs emphasizes the full and effective integration of clinical pharmacists into the healthcare team, which can serve as a potential preventive strategy to lower the occurrence of TRPs.
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