Does anyone in the home care setting have policies and/or guidelines about starting a patient on TPN at home. This is not our policy but am being asked about doing this. I am not feeling comfortable at all. Any information would be helpful. Thanks for your feedback. Holli Wiseman RN, MS
Holli,
I have done several home start TPN patients. I did have the great fortune of a fantastic CNSD who managed the pt. First, we did a comprehensive eval of the pt for refeeding risks and general pt condtion. Second, as a rule the RD would start out at 1/4 goal with frequent lab and advance as tolerated to goal over about a week. This ran for 24 hours. Once we were at goal formula then we began to taper down to cyclic infusions usually 12-18 hours at night. I know much of what I have said is vague but, each pt was managed based on their responce. I no longer work for this company and thus done have access to the policy. As I said I have done several without much difficulty. I think you can do it safely with close monitoring. Good luck. Contact me off line at [email protected] if you want more. Craig
Craig Farris RN, CRNI
Clinical Nurse liaison
We do a lot of home TPN. I use the TPN information from "The A.S.P.E.N Nutritional Support Patient Education Manual" when doing the teaching. It is an excellant resource. I have a P&P you can review as well if you send me your email address.
Valorie Dunn,BSN, RN, CRNI, PLNC