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Comment on this procedure
STANDARDS:
* Total Parenteral Nutrition (TPN) is ordered by the Duty Intensivist. TPN may be administered by Registered Nurses who are accredited to give intravenous medication and have undertaken training to care for CVC sites and lines.
* The position of the CVC must be confirmed by chest XR prior to commencement of TPN.
* TPN must be infused via a dedicated lumen of the CVC. Line integrity is not to be compromised except for bag/line change or CVC removal. No bolus injections may be given into a TPN line.
* TPN must be infused via a volumetric pump at a constant rate over 24 hours as specified by the Intensivist.
* Care of CVC as per CVC dressing protocol.
* Change of TPN line as per CVC line change protocol.
* TPN bag change at 1900 hours. Bag must be checked by two registered nurses against orders, patient identification, date of expiry and for any sign of contamination.
* TPN bag change as per CVC line change protocol, except TPN line is retained and is used for 72 hours.
* TPN bag is protected against light.
* Nursing observations required:
- Q4H TPR. If temperature over 38 degrees Celcius, notify M.O.
- Daily ward urinalysis as per urinalysis protocol.
- Strict fluid balance charting of input and output.
- Daily weigh.
- Baseline and routine laboratory investigations as per table.
OUTCOMES:
* TPN is administered in a safe manner, the patient experiences no infection from contamination of CVC or TPN administration.
R : 33.1
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