[Music] your prescriber has ordered parenteral nutrition therapy that will be administered through an infusion pump this educational video will provide you with step-by-step instructions on how to administer your parenteral nutrition infusion effectively and safely throughout this video we will use the term parenteral nutrition or pn your prescriber may also refer to pn therapy as either tpn or hpn this educational video is for parental nutrition that is administered in one bag per day if your pn solution requires lipids to be infused separately and you have two bags per day please refer to the appropriate separate video for a two bag infusion it is very important to clean your hands between every step of the pn preparation process including before handling the pn bag before and after cleaning your work area and pee and mat before and after gathering supplies before starting the infusion and whenever you think your hands may have become contaminated clean hands thoroughly using soap and warm water follow by drying hands with a clean towel if no soap and water is available use an alcohol-based hand sanitizer prior to preparing your pn solution for administration select an uncluttered work area clean the work area with warm soapy water or antimicrobial cleaning agent remove the pn bag from the refrigerator and place on the pn preparation mat read the label to determine the amount of time needed to allow the pn bag to reach room temperature before administration never speed the warming process by heating or microwaving the solution carefully read the pn label and verify the correct name of patient volume and amount of pn ingredients and expiration date if any of the information on the label is incorrect please call us carefully inspect the pn bag for floating particles cloudiness discoloration or leaks if any of those are present do not use and promptly call us carefully observe the color of the pn solution pn solutions will be clear if it does not contain lipids or milky if it contains lipids you can determine if your pn solution contains lipids by reading the label if the color of your pn solution is different than previously provided by option care health please promptly call us gather all supplies including iv tubing with filter flush syringes alcohol wipes syringes with needles and any pn additives place them on the pn preparation mat as indicated pn additives may include vitamins other nutrients or medications be sure you have each additive listed on the pn bag label place infusion pump on the clean work area please note that your infusion pump may be different than the one pictured in this video place sharps and trash containers near your work area locate the injection port on the pn bag if there is a cover over the port remove it scrub the end of the port with an alcohol wipe for at least 15 seconds and allow to air dry do not let the port touch other surfaces once cleaned with alcohol locate the two vitamin files on your pn preparation mat remove the protective caps from the two vitamin files scrub the rubber stoppers of the vials with an alcohol wipe for 15 seconds and allow to air dry do not use a vial that is missing a protective cap promptly call us locate the empty syringe on your pn preparation mat if the syringe does not have a needle attached locate the needle remove the empty syringe and needle from their wrappers attach the needle to the syringe by twisting gently next draw air into the syringe by slowly pulling back the plunger of the syringe to the two millimeter mark place the vial on a hard surface and insert the needle straight into the rubber stopper of the first vitamin vial slowly inject all of the air into the vial making sure not to touch the needle tip to the solution inside the vial pick up the vitamin vial and turn upside down adjust the needle so the tip is in the fluid slowly withdraw all contents into the syringe be careful not to touch the needle when removing the vial using the same syringe repeat these steps with the second vitamin vial locate the injection port on the pn bag if the injection port has come into contact with anything since you cleaned it with alcohol clean it again and allow to air dry insert the needle straight into the pn bag's injection port be careful not to puncture the bag once the needle has been inserted into the injection port place your thumb on the plunger and slowly inject the vitamins into the pn bag remove the syringe and do not recap the needle dispose of the used syringe and needle into the sharps container for any additional additives follow the same process previously shown using a new syringe and needle once all additives have been added to the pn bag gently rotate the bag in order to mix the additives into the pn solution the additive should mix completely with the pn solution and produce an even color you are now ready to prepare your flush syringes and connect your pee and bag to the infusion pump for next steps please watch the kerlin or cad infusion pump video you can determine the specific pump model you've been given by looking at your infusion pump the information in this video is for educational purposes and is not intended to replace any medical advice or instructions that you have received from your physician or other health care provider if you have questions please call your optioncare health pharmacy at any time