1.     Introduction

Total Parenteral Nutrition (TPN) is defined as the process of supplying daily calorie requirements and other nutrient (proteins, fats, carbohydrates, vitamins, electrolytes, trace elements and water) via solely the parenteral route.

2.     Objective

To maintain an equilibrium between nutritional requirements and metabolic needs by supplying nutrients parenterally  for a period of time when a patient cannot take in food orally in sufficient amounts.

3.     Quality Assurance
 

The Laminar Air-Flow Cabinet (Class 100) and the Clean Room (Class 10,000) meet the requirement of Good Manufacturing Practice (GMP). The air supply is filtered using HEPA (High Efficiency Particulate Air) filters, which reduce chances of airborne particulate contamination. Validations of both the Laminar Air-Flow cabinet and Clean Room are carried out once a year. Routine basic microbiological monitoring is carried out i.e. exposure of settling plates with nutrient media for ambient airborne contamination.

Proper documentations and a good computer program are implemented to minimize errors in calculating nutritional requirements. Trained personnel to ensure strict aseptic technique during compounding so as to maintain the sterility of the nutritional solution that is critical in reducing the incidence and complication of sepsis in parenteral nutrition patients. Sterility test and assay (Nutrients and electrolytes) on the solution prepared are carried out.

Disinfectants and disinfections /sanitation procedures comply with the current disinfection policy.
 

4.     Achievement
 

     QAP Indicator:
 

Proportion of parenteral nutrition requests/prescriptions filled and solution compounded to total number requests/prescription received within the same working day. (Standard not less than 90% )  For 2002 our achievement was  100%