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Holli Wiseman
Starting TPN at Home

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

Craig Farris RN CRNI
Home TPN Start


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

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

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