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Uy
Clinical Pharmacy
Module 2
1. What are the advantages of home enteral and parenteral nutrition programs
over hospital-administered programs?
Home enteral nutrition is a treatment carried out frequently due to advantages for
patients and caregivers not only for the lower risk of nosocomial infections and
better integration in socio-familiar media but also for the health administration
because of the lower economic cost and the release of hospital beds. The
advantages of this program is to decrease the health costs related to lengthy
hospital stays, and reduce the need for outpatient and emergency department
visits for parenteral drug administration.
Patients who are suitable candidates for HPN will be provided initially with TPN
bags in the hospital. Therapy will continue until their medical condition is
stabilized. They can then undergo appropriate training to enable them to
administer their TPN bags at home. However, HPN patients may still require to
return to the hospital for regular check-ups. This means that pharmacists
involved in the care of HPN will require working knowledge of the procedures
adopted to provide care for patients in the hospital and at home.
Home total parenteral nutrition (TPN) presents many challenges to the home
health care team, with the increase in patient acuity, advance in technologies,
and increase in stringent guide lines set by insurance companies. A well-
managed home TPN program can provide benefits through decreased health
care cost to society and increased quality of life for the patient.
Comprehensive fluid management
• Includes TPN as well as Enteral feeds & Non-TPN IV infusions (such as arterial
line, dopamine infusion etc) to provide complete & precise fluid management.
• Very easy to learn. Requires less than 30 minutes of initial orientation to be able
to use the program proficiently. Extensive on line help makes data entry intuitive.
Highly customizable
• Maximum and minimum values for TPN additives & concentrations of solutions
used for TPN can be customized according to institutional policies
• e.g. Maximum dextrose concentration in peripheral lines, maximum osmolality in
peripheral lines, limits for proteins, lipids and other additives are all customizable