Quality and safety of parenteral nutrition for newborn and preterm infants as an on-ward preparation
| Autor: | Lucie Bouchoud, Pascal Bonnabry, Farshid Sadeghipour, Isabelle Sommer, Markoulina Berger-Gryllaki |
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| Rok vydání: | 2018 |
| Předmět: |
Quality Control
medicine.medical_specialty Parenteral Nutrition Pharmacy Microbial contamination 030226 pharmacology & pharmacy Nurse's Role 03 medical and health sciences Sample volume 0302 clinical medicine Internal medicine Medicine Humans Infant Health 030212 general & internal medicine Dosing Neonatology General Pharmacology Toxicology and Pharmaceutics Medical prescription Original Research Parenteral Nutrition Solutions business.industry Compounded preparations Infant Newborn Electrophoresis Capillary Parenteral nutrition business Drug Contamination Infant Premature |
| Zdroj: | Eur J Hosp Pharm |
| ISSN: | 2047-9956 |
| Popis: | Background For newborn and preterm infants, standardised and individual parenteral nutrition (PN) is used. PN preparation is at risk for contamination and dosing errors. The quality of PN is crucial for infants and has a direct impact on their health status and safety. Purpose The aim of this study is to evaluate the physicochemical and microbial quality of PN for newborn and preterm infants prepared on a neonatal ward. Methods Sampling of various individual PN prepared by nurses on a neonatal ward was performed. Formulations included maximal four electrolytes, variable dextrose and amino acid concentrations. Depending on the sample volume, up to three quality analyses were performed: (1) test for bacterial endotoxins by kinetic-chromogenic method, (2) sterility according to the European and US Pharmacopoeia, and (3) quantification of electrolytes by capillary electrophoresis and of dextrose by ultraviolet detection after enzymatic reaction of hexokinase. The concentrations obtained were evaluated based on the US and Swiss Pharmacopoeia specifications for compounded preparations and compared to the widened pharmacy specifications. Results The composition of 86% of the 110 analysed PN prepared by nurses on the neonatal ward corresponded to their medical prescription. 14% were out of the acceptable widened pharmacy ranges. We found no microbial contamination in the samples. All PN were free from endotoxins. Conclusion Component concentrations of PN prepared on wards by nurses differed frequently and significantly from their medical prescription, and the deviation can be critical depending on the component and its mode of action. The sample size is too small to evaluate the microbial contamination. |
| Databáze: | OpenAIRE |
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