Postneonatal mortality in England, Wales and Sweden.

Abstract

<h3>Background</h3> The preparation of total parenteral nutrition (TPN) is subject to a great deal of variability in clinical practice due to the complexity of TPN and the variety of professionals involved. Nutritional support is an important care activity in a pharmacy service. <h3>Purpose</h3> To evaluate the activity of a parenteral nutrition unit in a hospital pharmacy. <h3>Material and methods</h3> This was a retrospective study analysing TPN during 2015 in a pharmacy service of a tertiary hospital. Data were obtained from the pharmacy service’s nutritional database and the pharmacy service’s dashboard of activity and quality. Pharmaceutical care in adults patients is based on validating the indication to assess the patient’s nutritional status, calculating the nutritional requirements, developing a nutritional plan and deciding on the composition of the TNP. In paediatric patients, the clinical pharmacist´s functions with regard to TPN are to ensure the quality (stability and osmolarity) and safety of the solutions prepared. The formulations were prepared by the hospital pharmacy, in totally or from three compartment bags (commercial preparations), or prepared by an external service. <h3>Results</h3> During the study period, 1510 patients (698 adults, 812 children) were treated with TPN. 21 008 TPN were dispensed from the hospital pharmacy. In institutionalised patients, 16 576 TPN were dispensed (42% adults, 58% children); 4432 TPN were delivered to home patients (9% adults, 91% children). A total of 11 146 formulations were prepared in whole by the hospital pharmacy (37% adults, 63% children); 1197 TPN were commercial preparations (all in adults) and 8665 TPN were prepared by an external service (24% adults, 76% children). The prescribing units in adult TPN were: anaesthesia–intensive care medicine (40%); oncologic-haematologic patients (26%); surgery patients (26%); haemodialysis patients (2%); and other units (6%). In paediatric patients, the prescribing units were: neonatal–intensive care unit (71%); oncologic and haematologic patients (11%); surgery patients (11%); and other units (7%). <h3>Conclusion</h3> Most TPN (60%) were prepared by the hospital pharmacy and 40% of TPN were acquired through an external service. Most TPN were dispensed to paediatric patients (65%). They were mainly prepared for critically ill patients (46%). The department of pharmacy was involved in the management of TPN to support the clinical and therapeutic needs of the patient. No conflict of interest