Wastage of standardised parenteral nutrition solution – a challenge for neonatal units

Abstract

Background: Standardised parental nutrition (PN) has been used in many neonatal intensive care unit (NICU). Easy accessibility, better provision of nutrients, reduced prescription errors and cost savings are some of its benefits. Fixed large volume (e.g. 750–1000 mL) and short expiry limit (48 hrs) along with changing metabolic needs of neonates leads to significant wastage of PN solution.

Objective: To evaluate wastage of PN solution in our 22-bedded NICU.

Methods: The audit was conducted over 21-month period (July 2015–April 2017). Data on PN use (e.g. type, duration, infused volume, residual after use) was obtained from hospital records. The discarded volume of PN was estimated after subtracting the administered volume based on the rate of infusion from the total volume in the bag. Cumulative “discarded” volume as percentage of the total “supplied” volume was calculated.

Results: A total of 305-PN bags (Standardised: Preterm: 222, Term: 83) were used. The estimated total used, discarded, and percentage discarded volumes for standard preterm and term PN were 78.1, 88 L, 53% and 33.5, 49.7 L, and 59.8%, respectively.

Conclusions: There was more than 50% wastage of PN solution in our NICU. The estimated cost of this PN wastage was around 21,000 AUD over 21 months. Strategies such as minipack should be explored to prevent such losses.

Keywords:

• Audit
• cost
• neonate
• parenteral nutrition
• standardised

Disclosure statement

All authors declare that there is no competing interest involved. All authors declare that the work submitted has not been published previously, that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder.

Additional information

Funding

This research project received no grant from any funding agency in the public, commercial or not-for-profit sectors.