As we ring in the new year, we would like to help you, our readers, find new ways to renew your commitment to providing the highest quality infusion care possible. We hope that this special focus issue of the Journal of Infusion Nursing will help you by presenting some new insights into one of the nine core content areas of infusion nursing: total parenteral nutrition (TPN). With input from INS and the American Society of Parenteral and Enteral Nutrition (ASPEN), a special TPN focus was convened at the 2001 Annual Meeting in Indianapolis. The articles in this issue are the result of this collaborative effort.
It is essential for infusion nurses to understand the complex nature of this type of therapy: TPN often is a course of therapy needed for patients whose disease states are affected by malnutrition; however, others have conditions that cause nutritional deficiencies. Nurses must be cognizant of issues related to TPN administration for patients with chronic conditions that require life-long nutritional management. Nurses who understand the causes and effects of nutritional deficiencies are able to recognize and assess the nutritional requirements of their patients and, hence, have more successful outcomes.
An infusion nurse delivering TPN must be able to identify potential complications that are metabolic-related and treat those that might be related to the vascular access device. But infusion nurses should not be alone in their assessment. Because of the nature of TPN therapy and certain disease states (particularly in patients with chronic conditions), a collaborative effort is necessary to treat the patient effectively. We hope that healthcare providers will have an inclusive approach to treatment where nurses, doctors, dieticians, pharmacists and social workers lend their expertise to the process.
An important goal of nutrition management for all patient populations in all practice settings is providing support for the patient and caregiver to ensure safe TPN delivery. For instance, in the homecare setting, nurses must take steps to educate both the patient and caregiver to ensure that TPN therapy is being administered properly and errors are minimized. Both patient and caregiver should have a thorough understanding of the type of vascular access device used, the solutions being administered, admixing needs, and the associated equipment needs to identify and prevent complications. Nurses who provide TPN support for pediatric patients should be diligent about providing ongoing support to caregivers as the child grows. And as always, nurses who are cognizant of and able to use current technology for TPN will be able to better serve their patients.
INS looks forward to a prosperous and peaceful new year as you renew your commitment to infusion nursing.
FIGURE