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Published on: September 20, 2019
Aseptic techniques used to administer parenteral nutrition and home parenteral nutrition at intestinal failure
Jane Fletcher1, Hardip Malhi2, Annie Topping3
1Consultant Nurse for Nutrition and Intestinal Failure, University Hospitals Birmingham NHS Foundation Trust, Birmingham; Honorary Associate Professor, Department of Nursing and Midwifery, College of Medicine and Health, University of Birmingham.
Background:
Aseptic technique during the administration of parenteral nutrition/home parenteral nutrition (PN/HPN) errs towards poorly described traditional aseptic/sterile approaches. This study aimed to identify procedures and the evidence underpinning practice in intestinal failure centres.
Method:
A novel approach was taken using documentary analysis. PN/HPN administration procedures used at NHS England-commissioned intestinal failure centres were requested by email.
Results:
The response rate was 57%, and 16 documents were analysed. Techniques were described as aseptic technique (n=2), aseptic non-touch technique (n=6) or sterile aseptic non-touch technique (n=1) or were not named (n=7). Sterile gloves were used in 13 (81%) procedures described and non-sterile gloves in 3 (19%). A sterile field was recommended in most procedures (94%). Scrub time of the hub was not stipulated in 7 (44%) procedures. Few documents included relevant citations or evidence.
Conclusion:
There is variation in aseptic techniques used to administer PN/HPN in intestinal failure centres with no clear evidence base. Nurses need to review procedures to ensure practice is evidence based and environmentally sustainable.
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