This patient care pathway provides steps and online resources — from initial assessment of need to transition to home — for patients who may require parenteral nutrition (PN). Click on resources to pull up documents, checklists, and websites. Please note that, though the majority of these materials are open-source, some require a subscription in order to obtain access to full journal articles.
This pathway was developed by the ASPEN PN Safety Committee.
Pathway development supported by
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Step: 1
- Determine if patient is an appropriate candidate for PN
Step: 2
- Determine nutrient and therapy goals
Step: 3
- Assess if patient has appropriate venous access in place
Step: 4
- Use Computerized Provider Order Entry (CPOE) when able
- Use Clinical Decision Support tools
Step: 5
- Communicate PN prescription to pharmacy using electronic means with minimal transcription
Step: 6
- Clinical review
- Pharmacologic review
- Communication and order modification with prescriber as needed
Step: 7
Option: 1
Option: 2
Option: 3
Step: 8
- Initiate PN administration using PN Administration Checklist
Step: 9
- Initiate monitoring protocol
- Evaluate efficacy and goals of therapy
Step: 10
- Verify insurance coverage and identify home infusion provider
- Educate patient and caregivers on home PN and supports
- Identify prescriber
- Communicate discharge PN order, labs, frequency and monitoring parameters to home infusion company
Step: 11
- Develop error reporting program
- Implement infection control for CLABSI
- Monitor appropriate PN use
- Maintain glucose control
- Monitor readmissions of home PN patients