1
FACULTY OF NURSING AND MIDWIFERY
BSc (HONS) NURSING
AN OVERVIEW OF WASTAGE OF TOTAL PARENTERAL NUTRITION IN
NEONATAL INTENSIVE CARE UNIT,THOMSON HOSPITAL KOTA
DAMANSARA.
BANU PRIYA S PALANIAPPAN
BNUR19046641
09 SEPTEMBER 2021
A DISSERTATION SUBMITTED IN PARTIAL FULFILMENT OF THE
REQUIREMENTS OF THE DEGREE OF BSC (HONS) NURSING
,2
ACKNOWLEDGEMENT
I am using this opportunity to express my gratitude to everyone who supported me
throughout the course of this dissertation assignment. I am thankful for their aspiring
guidance, invaluably constructive criticism and friendly advice. I am sincerely grateful to
them for sharing their truthful and illuminating views related to the assignment.
I express my warm thanks to my supervisor, Mr Sarmilan for his support and constructive
comments.
I would also like to thank my family, colleagues and my superior for supporting me
throughout the years.
Thank you
Banu Priya S Palaniappan
BNUR19046641
,3
ABSTRACT
Background: In many neonatal critical care units, individualized complete parental nutrition
(TPN) have been used (NICU). It has a number of customised to meet the nutritional
requirements of each particular patient. At Thomson Hospital Kota Damansara, all Pediatric
hospital, 22% of TPN prescriptions needed explanation of inaccuracies, with pharmacists
spending a minimum of ten minutes each order correcting problems. Through standardizing
TPN formulas and implementing TPN ordering procedures through into electronic health
records, performance improvement techniques increased safety of patients.
Methods: TPN solutions for newborn and pediatric patients were created by a diverse group
of clinicians. The criteria for inclusion, exclusion, as well as discontinuance were established.
The major end measure was lowering the rate of TPN ordering errors, with additional
objectives including faster TPN ordering and processing and fewer blood samples. We
standardized TPN solutions, put them into to the electronic health records, analyzed blood
draws, and assessed operational efficiencies throughout numerous blueprint cycles.
Considering independent samples, chi-square analyses of independence as well as t - test are
being used to analyze the data.
Results: Throughout the last quarter of the research process, the TPN ordering error rate
reduced considerably between 22 percent to 3.2 percent, 2 (1, N = 2,467) = 89.13, P-value of
0.001. By the completion of the project, order processing duration has decreased from 10 to 5
minutes. Within last qtr of the research, the mean volume of blood draws reduced
considerably from 6.2 (Standard deviation = 3.12 to 4.3 and (Standard deviation = 2.13), t
(506) = 5.97, P-value is 0.001.
, 4
Conclusions: TPN standardization and the switch to electronic ordering resulted in
considerable reductions in order mistakes as well as processing time. It also enhanced
resource productivity by cutting down on the amount of blood draws.
FACULTY OF NURSING AND MIDWIFERY
BSc (HONS) NURSING
AN OVERVIEW OF WASTAGE OF TOTAL PARENTERAL NUTRITION IN
NEONATAL INTENSIVE CARE UNIT,THOMSON HOSPITAL KOTA
DAMANSARA.
BANU PRIYA S PALANIAPPAN
BNUR19046641
09 SEPTEMBER 2021
A DISSERTATION SUBMITTED IN PARTIAL FULFILMENT OF THE
REQUIREMENTS OF THE DEGREE OF BSC (HONS) NURSING
,2
ACKNOWLEDGEMENT
I am using this opportunity to express my gratitude to everyone who supported me
throughout the course of this dissertation assignment. I am thankful for their aspiring
guidance, invaluably constructive criticism and friendly advice. I am sincerely grateful to
them for sharing their truthful and illuminating views related to the assignment.
I express my warm thanks to my supervisor, Mr Sarmilan for his support and constructive
comments.
I would also like to thank my family, colleagues and my superior for supporting me
throughout the years.
Thank you
Banu Priya S Palaniappan
BNUR19046641
,3
ABSTRACT
Background: In many neonatal critical care units, individualized complete parental nutrition
(TPN) have been used (NICU). It has a number of customised to meet the nutritional
requirements of each particular patient. At Thomson Hospital Kota Damansara, all Pediatric
hospital, 22% of TPN prescriptions needed explanation of inaccuracies, with pharmacists
spending a minimum of ten minutes each order correcting problems. Through standardizing
TPN formulas and implementing TPN ordering procedures through into electronic health
records, performance improvement techniques increased safety of patients.
Methods: TPN solutions for newborn and pediatric patients were created by a diverse group
of clinicians. The criteria for inclusion, exclusion, as well as discontinuance were established.
The major end measure was lowering the rate of TPN ordering errors, with additional
objectives including faster TPN ordering and processing and fewer blood samples. We
standardized TPN solutions, put them into to the electronic health records, analyzed blood
draws, and assessed operational efficiencies throughout numerous blueprint cycles.
Considering independent samples, chi-square analyses of independence as well as t - test are
being used to analyze the data.
Results: Throughout the last quarter of the research process, the TPN ordering error rate
reduced considerably between 22 percent to 3.2 percent, 2 (1, N = 2,467) = 89.13, P-value of
0.001. By the completion of the project, order processing duration has decreased from 10 to 5
minutes. Within last qtr of the research, the mean volume of blood draws reduced
considerably from 6.2 (Standard deviation = 3.12 to 4.3 and (Standard deviation = 2.13), t
(506) = 5.97, P-value is 0.001.
, 4
Conclusions: TPN standardization and the switch to electronic ordering resulted in
considerable reductions in order mistakes as well as processing time. It also enhanced
resource productivity by cutting down on the amount of blood draws.
