Effect of clinical pharmacists participating in parenteral nutrition support intervention in patients hospitalized in hepatobiliary and pancreatic surgery

Abstract

Objective To evaluate the effect of clinical pharmacists on parenteral nutrition support interventions, and to provide reference for clinical pharmacists to participate in the ERAS Nutrition Support Group work model. Methods A total of 490 patients hospitalized in department of hepatobiliary and pancreatic surgery from November 2016 to January 2017 were selected as control group. 521 patients hospitalized in department of hepatobiliary and pancreatic surgery from November 2018 to January 2019 were selected as intervention group. Nutritional risk, parenteral nutrition support indications, parenteral nutrition prescription energy and amino acid supply, prescription incompatibility and rationality, prescription osmotic concentration and phlebitis, parenteral nutrition and drugs in Y-tube compatibility of the above patients were analyzed to evaluate the effect of interventions by clinical pharmacists after participating in the nutritional support team. Results Patients with benign pancreatic diseases in the two groups had higher incidence of nutritional risk (78.2%, 75.6%), and patients with benign biliary diseases had lower incidence of nutritional risk (76.4%, 69.9%). Incidence of patients having parenteral nutrition support indications, namely NRS 2002≥3 points was higher in intervention group (83.6%) than in control group (56.6%); parenteral nutrition prescription energy and amino acid supply were higher in intervention group than in control group, patients in the intervention group had lower blood albumin dosage and no over-indication medication than patients in the control group; patients in both groups had no parenteral nutrition prescription safety issues such as glycolipid ratio (kJ∶kJ) 0.05). The compatibility of parenteral nutrition solution and drug in Y-tube was lower in the intervention group than in the control group. Conclusion The participation of clinical pharmacist in the ERAS nutrition treatment team, who will assist the doctor in formulating the nutritional treatment plan, monitor the patient's nutritional support and conduct regular indoor training, can effectively improve the reasonable application of parenteral nutrition support, standardize the use of therapeutic drugs, and guide patients and caregivers to use the preparations safely so that to ensure patients' safety in clinical interventions. Key words: Department of hepatobiliary and pancreatic surgery; Clinical pharmacist; Nutritional Risk; Parenteral nutrition support; Total nutrition admixture