Extending total parenteral nutrition hang time in the neonatal intensive care unit: Is it safe and cost effective?. Issue 1 (17th December 2012)

• Record Type: Journal Article
• Authors: Balegar V, Kiran Kumar; Azeem, Mohammad Irfan; Spence, Kaye; Badawi, Nadia
• Is Part Of: Journal of paediatrics and child health. Volume 49:Issue 1(2013:Jan.)
• Page Start: E57
• Page End: E61
• Publication Date: 2012-12-17
• Subjects: Children -- Health and hygiene -- Periodicals; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/jpc.12023
• Languages: English
• ISSNs: 1034-4810

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jpc12023-sec-0001" sec-type="section"> <title>Aim</title> <p>To investigate the effects of prolonging hang time of total parenteral nutrition (TPN) fluid on central line–associated blood stream infection (CLABSI), TPN‐related cost and nursing workload.</p> </sec> <sec id="jpc12023-sec-0002" sec-type="section"> <title>Methods</title> <p>A before–after observational study comparing the practice of hanging TPN bags for 48 h (6 February 2009–5 February 2010) versus 24 h (6 February 2008–5 February 2009) in a tertiary neonatal intensive care unit was conducted. The main outcome measures were CLABSI, TPN‐related expenses and nursing workload.</p> </sec> <sec id="jpc12023-sec-0003" sec-type="section"> <title>Results</title> <p>One hundred thirty‐six infants received 24‐h TPN bags and 124 received 48‐h TPN bags. Median (inter‐quartile range) gestation (37 weeks (33, 39) vs. 36 weeks (33, 39)), mean (±standard deviation) admission weight of 2442 g (±101) versus 2476 g (±104) and TPN duration (9.7 days (±12.7) vs. 9.9 days (±13.4)) were similar (<italic>P</italic> > 0.05) between the 24‐ and 48‐h TPN groups. There was no increase in CLABSI with longer hang time (0.8 vs. 0.4 per 1000 line days in the 24‐h vs. 48‐h group; <italic>P</italic> < 0.05). Annual cost saving using 48‐h TPN was AUD 97 603.00. By using 48‐h TPN, 68.3% of nurses indicated that their workload decreased and 80.5% indicated that time spent changing TPN reduced.</p> </sec> <sec id="jpc12023-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Extending TPN hang time from 24 to 48 h did not alter CLABSI rate and was associated with a reduced TPN‐related cost and perceived nursing workload. Larger randomised controlled trials are needed to more clearly delineate these effects.</p> </sec> </abstract>