Parenteral Nutrition Therapy Guide

Overview

Parenteral Nutrition (PN): Also known as TPN (Total Parenteral Nutrition), HPN (Home Parenteral Nutrition).
This guide covers PN administered in one bag per day.
Separate instructions required for PN with lipids infused separately.

Clean hands thoroughly with soap and warm water or alcohol-based hand sanitizer.
Essential steps to clean hands:
- Before handling the PN bag
- Before and after cleaning work area and PN mat
- Before and after gathering supplies
- Before starting infusion
- Whenever hands may be contaminated

Work Area: Select and Clean
- Choose an uncluttered area
- Clean with warm soapy water or antimicrobial cleaner
PN Bag Preparation
- Remove from refrigerator, place on PN preparation mat
- Read label for name, volume, ingredients, expiration date
- Inspect for particles, cloudiness, discoloration, leaks
- Check solution color (clear if no lipids, milky if lipids are present)
Supplies Gathering
- IV tubing with filter, flush syringes, alcohol wipes, syringes with needles
- PN additives: vitamins, nutrients, medications
- Set up the infusion pump and place sharps and trash containers nearby

Injection Port Preparation
- Locate injection port on the PN bag
- Remove cover and scrub with alcohol wipe for 15 seconds, air dry
Vitamin Addition
- Remove caps from vitamin vials, scrub rubber stoppers with alcohol wipe, air dry
- Attach needle to syringe, draw air into the syringe (2 ml mark)
- Inject air into the vial, withdraw contents into syringe, repeat for second vial
Inject Additives into PN Bag
- Clean injection port again if needed
- Inject vitamins into the PN bag, remove syringe, dispose of it in sharps container
- Follow same steps for any additional additives
- Gently rotate the PN bag to mix additives thoroughly