Jpen Parenter Enter
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Jpen Parenter Enter · Mar 2012
Compounding USP <797>: inspection, regulation, and oversight of sterile compounding pharmacies.
Using USP Chapter <797> Pharmaceutical Compounding-Sterile Preparations (CSP) is now considered the standard for sterile compounding practice and safety in the United States. This is particularly important in compounding the complex formulation of parenteral nutrition.
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The drug shortage crisis continues in the United States and threatens the integrity of the pharmaceutical supply chain and compromises patient care, especially patients requiring parenteral nutrition (PN) therapy. The number of new drug shortages has increased rapidly over the past 5 years, with the most significant increase in sterile injectable products. The most common reason for a shortage of a sterile injectable medication is a product quality issue. ⋯ The American Society for Parenteral and Enteral Nutrition also conducted a survey of healthcare professionals regarding PN product shortages and the associated patient care implications. Safety risks were reported throughout the entire PN process, from procurement of PN products to patient outcomes. Providing PN therapy during product shortages requires vigilance and continuous assessment of the entire PN process to optimize patient care quality and avoid patient harm.
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Parenteral nutrition (PN) is a complex prescription consisting of many components such as dextrose, amino acids, electrolytes, vitamins, trace elements, and/or intravenous fat emulsions. The ordering process is inconsistent and has led to PN errors. PN prescriptions require knowledge, education for prescribers, and standardized processes.
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Safe practices for sterile compounding are essential to preventing errors, particularly with parenteral nutrition (PN). This article reports several areas of errors in PN processes and provides recommendations for error prevention.
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Jpen Parenter Enter · Mar 2012
Enteral feeding induces early intestinal adaptation in a parenterally fed neonatal piglet model of short bowel syndrome.
Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and enteral nutrition. ⋯ This new model demonstrated profound SI adaptation, initiated early postsurgery by polyamine synthesis and crypt cell proliferation and only in response to enteral feeding. These changes translated to greater gut mass and length within days, likely improving functional capacity long term.