An audit to assess the compliance of TPN administration documentation

Abstract

Introduction: Parenteral nutrition (PN) is classified as a high-alert medication. The GGC (Greater Glasgow and Clyde) Intravenous Medicine Administration guidelines recommend that all intravenous medications, including TPN (total parenteral nutrition), must be checked by two registered practitioners before administration. Aim: The main purpose of this audit is to verify that the documentation for the administration of TPN prescriptions is being done according to guideline recommendations. Method: PN (parenteral nutrition) prescriptions for 19 inpatients from three different wards at Glasgow Royal Infirmary were included in this study. A patient Kardex was obtained to assess whether the TPN was prescribed and signed by two different nurses. The PN prescription form was also obtained to assess whether it was signed and checked by two different nurses and whether it documented the date and time at which the patient was administered a TPN bag. Results: Based on the Kardex records, 100% of the patients in this study (19 out of 19) were prescribed TPN their Kardex. Out of 430 TPN bags, only 15% had been checked by two different nurses, and many of them (41%) had been signed by only one. The majority (44%) had not been signed at all. When the prescriptions form were examined, it was found that based on 400 TPN bag, only 38% had been signed by two different nurses, and the majority (42%) had been signed by only one. The time and date should be documented on the prescription form, only 69% of the forms noted the date, and 43% noted the time. Discussion and Conclusion: Documentation of the TPN date and time did not follow the standard guidelines in most cases, which may affect patient safety and increase the costs of the health organization.

Therefore, it is essential to ensure that safeguards are put in place to reduce the likelihood of PN administration errors.

Introduction: Parenteral nutrition (PN) is classified as a high-alert medication. The GGC (Greater Glasgow and Clyde) Intravenous Medicine Administration guidelines recommend that all intravenous medications, including TPN (total parenteral nutrition), must be checked by two registered practitioners before administration. Aim: The main purpose of this audit is to verify that the documentation for the administration of TPN prescriptions is being done according to guideline recommendations. Method: PN (parenteral nutrition) prescriptions for 19 inpatients from three different wards at Glasgow Royal Infirmary were included in this study. A patient Kardex was obtained to assess whether the TPN was prescribed and signed by two different nurses. The PN prescription form was also obtained to assess whether it was signed and checked by two different nurses and whether it documented the date and time at which the patient was administered a TPN bag. Results: Based on the Kardex records, 100% of the patients in this study (19 out of 19) were prescribed TPN their Kardex. Out of 430 TPN bags, only 15% had been checked by two different nurses, and many of them (41%) had been signed by only one. The majority (44%) had not been signed at all. When the prescriptions form were examined, it was found that based on 400 TPN bag, only 38% had been signed by two different nurses, and the majority (42%) had been signed by only one. The time and date should be documented on the prescription form, only 69% of the forms noted the date, and 43% noted the time. Discussion and Conclusion: Documentation of the TPN date and time did not follow the standard guidelines in most cases, which may affect patient safety and increase the costs of the health organization.

Therefore, it is essential to ensure that safeguards are put in place to reduce the likelihood of PN administration errors.

Introduction: Parenteral nutrition (PN) is classified as a high-a