Abstract
Total parenteral nutrition for hospitalized critically ill patients is essential for improving outcomes, insufficient nutritional support lead to occurrences of complications, increased morbidity and mortality rates, increased length of hospital stay. Critical care nurses are the cornerstone in preventing theses complications. Aim: To investigate the effect of implementing total parenteral nutrition nursing guidelines on adult critically ill patients’ outcomes. Design: Non randomized prospective research design was used to utilize this study Subjects: convenience samples of 60 patients were assigned equally to study and control group at intensive care units at Assiut University hospitals. The control group received routine hospital care during TPN administration while, the study group received the developed guidelines for TPN during a period from January 2018 to December 2018. Methods Each patient in both groups were assessed by taking history, clinical examination, nutritional assessment laboratory investigation. Patients in study groups were received care according to developed total parenteral nutrition guidelines to determine outcome and complications in both groups. Results Finding of the present study revealed that significant improvement in study group with values of less than p=001 compared to control group Conclusion : implementing of total parenteral nutrition guidelines improve the outcomes and reduce the occurrence of complications among critically ill patients. Keywords : total parenteral nutrition, nursing guidelines, critically ill patient, outcomes DOI : 10.7176/JHMN/61-04 Publication date : April 30 th 2019
Highlights
Total Parenteral Nutrition (TPN) is the special formula of nutrition administered via a peripherally inserted central catheter (PICC), or a central venous line (CVC)
Inadequate or inappropriate nutritional support lead to increased mortality and morbidity rates, prolonged intubation, weakened respiratory muscles and failure of weaning from mechanical ventilation, increased length of intensive care unit (ICU) and hospital stay and infections that can lead to sepsis, multi organ failure, and even death ( Smith & Young,2015).total parental nutrition (TPN) administered to critically ill patients based on the patient’s clinical history, laboratory data,anthropemetric data as weight, height and arm skin folds,and current requirements including macro and micronutrients component administered intravenous under sterile technique
Subjects: A convenience sample of sixty patients of both adult sex were classified into two study and control groups and received TPN in ICUs at Assiut university hospital .Control group received at Assiut university hospital at Assiut university hospital routine hospital care during TPN administration While, the study group received the developed guidelines for TPN
Summary
Total Parenteral Nutrition (TPN) is the special formula of nutrition administered via a peripherally inserted central catheter (PICC), or a central venous line (CVC). Short-term TPN (7 to 10 days) or long-term TPN (>10 days) is used to treat patients whose GI tract is not functioning or not accessible for various reasons and is administered continuously until enteral feeding can be re-established (Perry & Potter ,2016). Inadequate or inappropriate nutritional support lead to increased mortality and morbidity rates, prolonged intubation, weakened respiratory muscles and failure of weaning from mechanical ventilation, increased length of ICU and hospital stay and infections that can lead to sepsis, multi organ failure, and even death ( Smith & Young,2015).TPN administered to critically ill patients based on the patient’s clinical history, laboratory data ,anthropemetric data as weight, height and arm skin folds ,and current requirements including macro and micronutrients component administered intravenous under sterile technique.
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