REDUCING THE INAPPROPRIATE USE OF PARENTERAL-NUTRITION IN AN ACUTE-CARE TEACHING HOSPITAL

Background: Parenteral nutrition IPN) is a form of nutrition that can be life-saving, but its use has inherent risks and it is expensive. Nu trition support teams have been shown to reduce both the rate of compl ications and excessive use of PN. Methods: Criteria were established t o evaluate the appropriateness of PN use in a 487-bed community teachi ng hospital. A prospective study of 50 consecutive patients, who recei ved either central or peripheral PN, was conducted. Results: The 50 pa tients received 469 days of PN. We found that 233 (49.7%) of the 469 d ays of PN were avoidable. This resulted in the creation of a formal ap proval process that required prior approval by a physician-directed mu ltidisciplinary advisory committee before PN could be instituted. The amount of PN subsequently decreased from 500 patient days of PN per mo nth to less than 100. Conclusions: This study supports the idea that i nappropriate use of PN can be reduced by physician education plus the continuing oversight of a physician-directed multidisciplinary advisor y group.