Quality improvement for parenteral nutrition in hospital: Applying a gap analysis to an electronic health record to review parenteral nutrition processing.

IF 2.1 4区 医学 Q3 NUTRITION & DIETETICS Nutrition in Clinical Practice Pub Date : 2024-12-18 DOI:10.1002/ncp.11254
Andrea Kulyk, Jolayne Dahmer, Leah Gramlich
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引用次数: 0

Abstract

Background: In light of the complex and high-risk nature of parenteral nutrition (PN), reviewing PN processing steps is essential to minimize patient harm. The main steps include ordering, verification, compounding, and administration. Electronic health records (EHRs) have become increasingly utilized and can play a critical role in enhancing the safety of PN processin. Epic EHR is used throughout all PN processing steps within our health system. There is limited literature on health system quality improvement initiatives in PN processing.

Methods: We reviewed the steps of PN processing in our health region and applied a gap analysis to assess Epic's functionality in PN processing. This gap analysis aimed to identify opportunities to enhance PN safety.

Results: Epic applies 32 of 40 functions that enhance PN safety. We selected three functions to prioritize adding into future EHR iterations; these include (1) bidirectional automatic interfacing between the automated compounding device and EHR reflecting real-time updates on product availability/shortages, (2) automatically transmitting a pharmacist-modified PN order back to the prescriber for approval, and (3) adding additional clinical decision support tools, one of which is incorporating a 3-in-1 qualification calculator and the second is requiring prescriber justification for using compounded formulations over multichamber bags. Additional opportunities for improving safety in PN processing were identified and added to the gap analysis.

Conclusion: Using a gap analysis is a simple process to review a health system's EHR to identify opportunities to enhance patient care.

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来源期刊
CiteScore
6.00
自引率
9.70%
发文量
128
审稿时长
3 months
期刊介绍: NCP is a peer-reviewed, interdisciplinary publication that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. This journal is a member of the Committee on Publication Ethics (COPE).
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