Automated Compounder for Adding Ingredients to Parenteral Nutrient Base Solutions

Dickson, Lori B.; Somani, Shabir M.; Herrmann, Gregg; Abramowitz, Paul W.

doi:10.1093/ajhp/50.4.678

Cited by 13 publications

(10 citation statements)

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“…Apart from the analysis of costs, individual preparation of PN gives the possibility of considerable errors in the calculation and the actual compounding, which can occur remarkably often even in a hospital pharmacy and 1.68 times more often if the production is done at the ward. 27,28 Both compounding errors and contamination can have serious consequences for the patient. 2 Due to this reason, ward compounding is avoided in some countries (for example, France and the UK).…”

Section: Discussionmentioning

confidence: 99%

Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study

et al. 2012

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“…Several studies have compared the cost of different PN compounding methods,[27–29] but there have been no investigations of costs associated with differential infection rates for various methods of PN preparation. The purpose of this study was to compare per-patient costs associated with compounded PN versus pre-mixed multi-chamber bag (MCB) PN based on underlying infection risk.…”

Section: Introductionmentioning

confidence: 99%

Nutrition Therapy Cost Analysis in the US

Turpin

Canada

Liu

et al. 2011

Applied Health Economics and Health Policy

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BackgroundBloodstream infections (BSI) occur in up to 350 000 inpatient admissions each year in the US, with BSI rates among patients receiving parenteral nutrition (PN) varying from 1.3% to 39%. BSI-attributable costs were estimated to approximate $US12000 per episode in 2000. While previous studies have compared the cost of different PN preparation methods, this analysis evaluates both the direct costs of PN and the treatment costs for BSI associated with different PN delivery methods to determine whether compounded or manufactured pre-mixed PN has lower overall costs.ObjectiveThe purpose of this study was to compare costs in the US associated with compounded PN versus pre-mixed multi-chamber bag (MCB) PN based on underlying infection risk.MethodsUsing claims information from the Premier Perspective™ database, multivariate logistic regression was used to estimate the risk of infection. A total of 44 358 hospitalized patients aged ≥18 years who received PN between 1 January 2005 and 31 December 2007 were included in the analyses. A total of 3256 patients received MCB PN and 41 102 received compounded PN. The PN-associated costs and length of stay were analysed using multivariate ordinary least squares regression models constructed to measure the impact of infectious events on total hospital costs after controlling for baseline and clinical patient characteristics.ResultsThere were 7.3 additional hospital days attributable to BSI. After adjustment for baseline variables, the probability of developing a BSI was 30% higher in patients receiving compounded PN than in those receiving MCB PN (16.1% vs 11.3%; odds ratio= 1.56; 95% CI 1.37, 1.79; p<0.0001), demonstrating 2172 potentially avoidable infections. The observed daily mean PN acquisition cost for patients receiving MCB PN was $US164 (including all additives and fees) compared with $US239 for patients receiving compounded PN (all differences p < 0.001). With a mean cost attributable to BSI of $US16 141, the total per-patient savings (including avoided BSI and PN costs) was $US1545.ConclusionIn this analysis of real-world PN use, MCB PN is associated with lower costs than compounded PN with regards to both PN acquisition and potential avoidance of BSI. Our base case indicates that $US1545 per PN patient may be saved; even if as few as 50% of PN patients are candidates for standardized pre-mix formulations, a potential savings of $US773 per patient may be realized.

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“…Similarly, HPN pharmacists communicating with the home infusion pharmacy involved in case 2 identified that the pharmacy involved was not using the software available for their ACD. Such software programs have been shown to improve compounding accuracy 5 , 14 . Prescribers should communicate uncommon compounding requests clearly and directly to the home infusion pharmacy to prevent confusion.…”

Section: Discussionmentioning

confidence: 99%

Home Parenteral Nutrition and Intravenous Fluid Errors Discovered Through Novel Clinical Practice of Reconciling Compounding Records: A Case Series

et al. 2017

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Home parenteral nutrition (HPN) and home intravenous (IV) hydration are complex, high-risk life-sustaining therapies for children and adults with severe digestive disorders. HPN compounding errors have the potential to cause serious patient harm. Here we present a retrospective case series at an interdisciplinary pediatric HPN program that includes specialized pharmacists reconciling prescriptions against commercial compounding records. Seven HPN or IV hydration patients were affected by significant errors in anion balance, copper, potassium, sodium, and infusion volume. Outpatient pharmacists' or other clinicians' review of compounding records as part of routine quality assurance process is critical for identifying and preventing errors.

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Automated Compounder for Adding Ingredients to Parenteral Nutrient Base Solutions

Cited by 13 publications

References 0 publications

Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study

Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study

Nutrition Therapy Cost Analysis in the US

Home Parenteral Nutrition and Intravenous Fluid Errors Discovered Through Novel Clinical Practice of Reconciling Compounding Records: A Case Series

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