Journal of Clinical Nutrition & Dietetics

Total parenteral nutrition follow up by dietitians is better and cheaper

World Congress on Nutrition and Dietetics
June 18-19, 2018 Paris, France

R. van Schaik, P Schepens, T Lanssens, B Vlaemynk, M Devisch, G Melssens, K Van den Abeele and T Niewold

General Hospital St Lucas, Bruges, Belgium
KU Leuven, Belgium

Posters & Accepted Abstracts: J Clin Nutr Diet

DOI: 10.4172/2472-1921-C1-003

Abstract

Introduction: Total parenteral nutrition (TPN) costs and malnutrition are a big financial burden for hospitals. In our hospital increasing TPN usage and costs and untreated malnutrition in patients had to be addressed. In 2009 a dietitian was appointed for malnutrition screening and monitoring of intramural patients with TPN and a nutritional management team was assembled. In the current study a procedure has been developed to assure optimal clinical nutritional care for all patients (oral, enteral and parenteral nutrition) and screening on malnutrition by EB practice tools. Purpose: TPN use and follow up according guidelines will reduce TPN use and costs by 10% in 2010 or 20% in 2010-2011. Method: TPN usage and costs over the years prior to 2010 were calculated. Causes for improper prescription of TPN were identified. TPN usage guidelines according EB ASPEN/ESPEN guidelines and procedures were developed. Nursing staff and dietitians were trained in proper administration and followed up of TPN and EN usage in patients. TPN-EN instruction tools for caregivers (physicians/dietitians) were presented, including risk for refeeding syndrome, and training on the job for dietitian teams/nutrition teams in other hospitals started. Inclusion of enteral and parenteral nutrition expertise in the job description of dietitians followed in 2017. Results: TPN usage decreased by 50%, cost savings on TPN usage of 48% was obtained and the number of TPN users declined by 39% in 2016 compared to 2010. In 2016, 92% of TPN patients were followed up by dietitians and a dietary treatment plan was available in the medical records.