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osmolality standards for PIV administration

I am in the process of arguing the policy we currently have regarding the pH and osmo acceptable for PPN. I am surprised to find that ASPEN guidelines reference an article from 1977. Who inthe forum works within ASPEN that can address this and ask why? We have better references for our INS standards on this topic and this should change, yes?!?


I am not quite sure what you

I am not quite sure what you are saying should change and in which direction. Can you be a little more specific about what you are asking? Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Patricia Jean

I had the same issue here in our organization with pharmacy implementing "pre-mixed PPN" with osmo of 815.  When I spoke to clinical pharmacist and discussed with him the INS standards of <600, he informed me that they go by ASPEN which states osmos at this level are acceptable for PIV. (Interestingly, he did agree on a personal level that 815 was "too much" and so now the goal is to either have PPN DC'd within 5 days or have the pt. moved over to central line and TPN.)

Wendy Erickson RN

Once we started our PICC Service in 1993, we eliminated the use of peripheral TPN altogether.  In order to run it peripherally, we had to "water it down" so much that we could never even come close to the protein/calorie needs of the patient.  It is just way too strong for peripheral veins.  We have a 24/7/365 PICC Service so if we lose a PICC in the middle of the night, it can be replaced. We never try to "limp along" until morning with a PIV.

Wendy Erickson RN
Eau Claire WI

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