Education Methods and Techniques for Training Home Parenteral Nutrition Patients

Gifford, Heather; DeLegge, Mark H.; Epperson, Lou Anne

doi:10.1177/0884533610379816

Cited by 17 publications

(14 citation statements)

References 31 publications

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“…provides detail about the essential elements of a thorough assessment and teaching program for HPN candidates. Thorough education is critical for HPN candidates to achieve independence and successfully transition to home from an acute care setting 17 …”

Section: Question 10: Which Patients Are Appropriate For Home Pn Thermentioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

177

202

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Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use. The recommendations contained in this document aim to delineate appropriate PN use and promote clinical benefits while minimizing the risks associated with the therapy. These consensus recommendations build on previous ASPEN clinical guidelines and consensus recommendations for PN safety. They are intended to guide evidence-based decisions regarding appropriate PN use for organizations and individual professionals, including physicians, nurses, dietitians, pharmacists, and other clinicians involved in providing PN. They not only support decisions related to initiating and managing PN but also serve as a guide for developing quality monitoring tools for PN and for identifying areas for further research. Finally, the recommendations contained within the document are also designed to inform decisions made by additional stakeholders, such as policy makers and third-party payers, by providing current perspectives regarding the use of PN in a variety of healthcare settings. (JPEN J Parenter Enteral Nutr. 2017;41:324-377) The etiology-based nutrition diagnoses in adults in clinical practice settings are as follows: Starvation-related malnutrition: Chronic starvation without inflammation (eg, anorexia nervosa). Chronic disease-related malnutrition: Inflammation is chronicand of mild to moderate degree (eg, organ failure, pancreatic cancer, rheumatoid arthritis, sarcopenic obesity). Acute disease or injury-related malnutrition:Inflammation is acute and of severe degree (eg, major infection burns, trauma, closed head injury). 2,3Malnutrition, pediatric: An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. It is recommended that growth charts based on a standard deviation z score system be used to track and assess nutrition status in children. 4,5Nutritionally-at-risk: Consider the individual nutritionally-atrisk if any of the following is present. Nutritionally-At-Risk Adult Summary of RecommendationsThese consensus recommendations are designed to identify best practices, guide day-to-day clinical decisions, reduce variations in practice, and enhance patient safety. They are not intended to supersede the judgment of the healthcare professional based on the circumstances of the individual patient.

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Section: Question 10: Which Patients Are Appropriate For Home Pn Thermentioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

177

202

View full text Add to dashboard Cite

show abstract

“…In addition, home nutrition support clinicians should follow up often with new HPN patients via phone call or with office visits to ensure comprehension of information and to monitor for symptoms. Patient support groups, newsletters, and webinars are other effective ways that patients can continue learning 20 …”

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

Metabolic Complications of Home Parenteral Nutrition

Davila

Konrad

2017

Nut in Clin Prac

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Home parenteral nutrition (HPN) has benefited countless patients since its initiation almost 5 decades ago. Over time, HPN has been found to be associated with various complications, including metabolic disorders. Metabolic complications can be grouped into short-term (eg, fluid imbalance, electrolyte disturbances, glucose abnormalities) and long-term (eg, hepatobiliary disorders, metabolic bone disease, iron deficiency anemia, manganese toxicity) categories. There are a number of treatment options for each complication. It is important to evaluate the entire clinical picture prior to initiating an intervention and use evidence-based interventions when available. A dedicated multidisciplinary team is best suited to prevent and manage complications when they are identified.

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“…Cultural norms and expectations may have also played a role in patients' ability to translate education into usual care at home. For example, attitudes about personal hygiene, self‐image, and modesty could have affected patients' ability to retain information learned and, more importantly, carry out HPN procedures as instructed 10 . From a process and systems perspective, education depth and breadth by trained NST nurses and resources used in delivering education (eg, the written instruction manual) could have been superior in the usual care group, preventing the intervention from having an additional effect.…”

Section: Discussionmentioning

confidence: 99%

“…Patient and family education is an essential component of predischarge preparation for patients with HPN. Education includes increasing patient and family knowledge about complications 4 – 6 , 10 , 11 . It is unknown if technology associated with Microsoft (Redmond, WA) PowerPoint (PP) presentation can be used to educate patients about HPN catheter care.…”

Section: Introductionmentioning

confidence: 99%