Twenty-four-hour single-container system for parenteral nutrient admixtures

Abstract

Development and implementation of a procedure for preparing parenteral nutrient (PN) solutions in 3-L containers at a 385-bed teaching hospital is described. After identifying problems in procedures for PN therapy, pharmacists collected time and cost data for preparing PN solutions using gravity flow and 1-L containers versus an automated compounding device and 3-L containers. They prepared a proposal for mixing a single daily solution in a 3-L container. A change in hospital policy to permit each PN solution to hang for 24 instead of 12 hours, a change in the pharmacy's schedule for preparing PN solutions, and a policy of hanging all fresh PN solutions between 1800 and 2400 were also proposed. After a one-month trial, the new procedures were adopted. To prepare an average of six PN solutions per day, time decreased from 5.32 to 2.33 hours. Inventory of PN supplies was reduced by 56%. Patients were charged approximately $25 less for three liters of PN solution. Standardized procedures improved efficiency of order filling. A standard procedure for preparing parenteral nutrient solutions in 3-L containers resulted in cost savings for the hospital and the patients and more efficient patient care.