Presenting The Role Of CPOE Incorporating With CDSS In Decreasing The Costs Of TPN In ICU

Abstract

Total parenteral nutrition (TPN) is the treatment modality of providing intravenous nutrition for patients who cannot get oral feeding. Physicians use standard scales, such as NRS-2002 and NUTRIC, for TPN orders. The usage of NRS-2002 in public hospitals has been mandatory in Turkey since 2015. The quality management department of Izmir Tire Public Hospital recognized that TPN consumption increased dramatically since 2015. The orders, which increased in direct proportion to the number of patients, showed that it should be investigated by evaluating their necessity according to nutritional practice standards. The objective of this study is to research the effect of e-orders incorporated with a clinical decision support system on TPN consumption. We digitalized the NRS-2002 form and added a clinical decision support system to calculate the score and calorie requirements. We found that the total number of NRS-2002 forms completed by physicians increased by 95%, the number of TPN orders decreased by 41%, and the cost decreased by 38% in 2018. This study showed that e-ordering of TPN combined with a clinical decision support system is beneficial for decreasing costs.