Total parenteral nutrition (TPN) is a medical method used to assist people who are afflicted with serious digestive issues as an attempt to ward off malnutrition. TPN's consist of a patient-specific formula of carbohydrates, fat, proteins, vitamins and minerals. Patients receive TPN's through intravenous administration. Because TPN's are injected directly into the bloodstream, it is imperative that they are prepared and administered in an aseptic or sterile manner. While hospital pharmacy technicians or nurses prepare TPN's under the direction of a licensed pharmacist, there are methods to follow to ensure sterility at home.
- Skill level:
- Moderately Challenging
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Things you need
- alcohol swabs
- hospital grade disinfectant
- sterile gauze pads
- base solution
- laminar flow hood
- Baxa compounder
- sterile gloves
- sterile alcohol spray
- surgical face mask
- surgical bonnet
- surgical protective gown
- surgical shoe covers
Obtain the patient-specific calculations for the prescribed TPN. These calculations need to be done by a licensed pharmacist who is working with the patient. TPNs are medical solutions that need to be dosed correctly to provide the proper nutrition for the patient.
Choose the correct base solutions, additives and syringes to make the TPN. Double check the medications to ensure they match the chosen ones for the formula.
Get dressed to enter the area of the laminar flow hood. In this order, put on your shoe covers, bonnet and face mask. Thoroughly wash your hands for thirty seconds and dry them off. Put your gown on and go near the laminar flow hood.
Put on your sterile gloves aseptically by not touching the fingertips to keep them sterile. Spray your hands with sterile alcohol and lay out your drugs inside the laminar flow hood. Place your solution bag and medications in the middle of the hood so that they are in the area of good air flow.
Wipe off the top of drug vials and solution bag ports with an alcohol swab. Use a separate swab for each item. Let the alcohol dry before drawing out any fluid.
Use aseptic technique to draw up the required amounts of drug to meet the necessary formula. Draw back your syringes to demonstrate the amount of drug you put into the bag of solution.
Set up the Baxa compounder if necessary. Large hospitals will use this machine to mechanically add the amount of medications to each TPN to expedite the process when they are filling many TPNs.
Tips and warnings
- Any patient requiring a TPN will typically receive their medication from a hospital pharmacy. Some nursing homes will get the formulas from a pharmacist and make their own TPNs.
- Aseptic technique is essential to keep a patient as healthy as possible. Practicing inadequate aseptic technique can expose a patient to serious infections.
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