Recently, I have looked into the utilization of premix PN (three chamber bag system). Below steps may help in assessing the utilization of premix PN
- Assess current PN utilization and patient population by performing utilization review
- Retrospective or prospective PN utilization review. (looking at the below criteria)
- Age group (Adult, pediatric, neonates)
- Central or peripheral PN
- Indications, comorbidity
- Short term or long-term
- Number of PN orders per day
- You may also asses pros and cons of each customized versus premix
1- Safety: Measured by ADR (Complication)
2- Efficacy: Since there is no single indicator to assess nutritional status. Efficacy can be assessed by comprehensive evaluation of weight, electrolytes level, hydration status, prealbmuin etc.
3- Cost: Direct (Cost of the PN bag customized versus premixed) and indirect (staffing and equipment)
Usually, stable young patients with no co-morbidity will tolerate ready-made PN and it’s a cost saving to the institution. However, if the majority of patient population is pediatric and neonates then customized can’t be replaced by ready-made.
Hope this will help