Safety in parenteral nutrition compounding
- PMID: 37584457
- DOI: 10.1002/ncp.11064
Safety in parenteral nutrition compounding
Abstract
Parenteral nutrition (PN) compounding is a complex process that requires knowledge and training to ensure the safety and efficacy of this form of nutrition support therapy. Unfortunately, errors and lack of adherence to safe PN compounding recommendations and sterile compounding requirements have resulted in patient injury and death. These lapses in the safe provision of PN have been the result of various factors, including a lack of understanding of PN compatibility, stability, and sterility requirements, as well as drug product shortages and order entry errors. This review will describe the current challenges with the education and training regarding PN compounding, compatibility and stability of PN admixtures, simultaneous administration of nonnutrient medications with PN admixtures, and specific challenges with special populations such as neonates, pediatrics, and those receiving home care.
Keywords: compounding; parenteral nutrition; parenteral nutrition formulas; safety.
© 2023 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.
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References
REFERENCES
-
- McKinnon BT. FDA safety alert: hazards of precipitation associated with parenteral nutrition. Nutr Clin Pract. 1996;11(2):59-65. doi:10.1177/011542659601100259
-
- Grissinger M. A fatal zinc overdose in a neonate: confusion of micrograms with milligrams. P T. 2011;36(7):393-409.
-
- Gupta N, Hocevar SN, Moulton-Meissner HA, et al. Outbreak of Serratia marcescens bloodstream infections in patients receiving parenteral nutrition prepared by a compounding pharmacy. Clin Infect Dis. 2014;59(1):1-8. doi:10.1093/cid/ciu218
-
- Centers for Disease Control and Prevention. Multistate fungal meningitis and other outbreaks. Published October 30, 2015. Accessed May 28, 2023. https://www.cdc.gov/hai/outbreaks/meningitis.html
-
- Drug Quality and Security Act. 21 USC §301 et seq (2013). https://www.congress.gov/113/plaws/publ54/PLAW-113publ54.pdf
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