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The Total Parenteral Nutrition

 

 

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
 

Year
Adult begs
Pediatric begs
Total
1991
364
444
808
1991
364
444
808
1992
355
334
689
1993
302
686
988
1994
212
521
733
1995
353
114
467
1996
458
97
555
1997 490 259 749
1998 493 250 743
1999 484 442 926
2000 696 292 988
2001 346 427 773
2002 400 534 934
   

 

     QAP Indicator:
 

 5.     Plans for 2003 5.1.        No. of bags to be compounded.  Min. of 800 bags.

5.2.        To continue counseling of TPN patient.