Abstract:
Parenteral nutrition (PN) is a complex preparation that contains multiple component products with the associated risk for incompatibilities and diminished stabilities when combined together as an admixture. Significant patient harm can result from prescribing, preparing, and administering PN without confirming compatibility and stability. Incompatibility or instability is rarely obvious to the unaided eye, so safe PN admixture relies on incorporating physicochemical properties of the included components into compatibility and stability decisions. Practices include applying active ingredient concentration limits to reduce risk for incompatibilities and instabilities. The purpose of the current article is to distill the wide-ranging information on PN compatibility and stability into a feasible blueprint that individual healthcare organizations can then use to design and implement practical initiatives. Compatibility and stability considerations can be incorporated into the routine tasks of PN prescribing, order reviewing, preparing, and administering. The focus of this review is on identifying potential physicochemical interactions that can be addressed at each step in the PN use process. Organizations should incorporate compatibility and stability considerations into the routine procedures and practices of all clinicians involved with PN therapy. Those clinicians in healthcare organizations and caregivers in the home should then be in a position to safely provide the appropriate PN admixtures in terms of compatibility and stability.
摘要:
肠胃外营养(PN)是一种复杂的制剂,含有多种成分产品,当作为混合物组合在一起时,存在不相容性和稳定性降低的相关风险。开处方可能会对患者造成重大伤害,准备,并在未确认相容性和稳定性的情况下施用PN。不相容性或不稳定性很少对肉眼可见,因此,安全的PN混合物依赖于将所含组分的物理化学性质纳入相容性和稳定性决定。实践包括应用活性成分浓度限制以降低不相容性和不稳定性的风险。本文的目的是将有关PN兼容性和稳定性的广泛信息提取到可行的蓝图中,然后各个医疗机构可以使用该蓝图来设计和实施实际计划。兼容性和稳定性考虑因素可以纳入PN处方的常规任务中,订单审核,准备,和管理。本综述的重点是确定可以在PN使用过程中的每个步骤中解决的潜在物理化学相互作用。组织应将兼容性和稳定性考虑纳入所有参与PN治疗的临床医生的常规程序和实践中。然后,医疗保健组织中的那些临床医生和家庭中的护理人员应该能够安全地提供在相容性和稳定性方面的适当的PN混合物。