Journal Club

TPN in the Home Setting

 

 

brought to you by

Click on the link at left to go to your desired page:  Page 1  Page 2  Page 3  Page 4  Page 5  Post-Test

Instructions

Take Another Course

Post-Test

 

Objectives:

Upon completion of this course, participants will be able to identify and define the primary complication associated with TPN that has been noted by the authors as the principle cause of most feeding-related problems. They will also be able to define several other complications associated with TPN in the home setting, including their frequency and why they occur. Participants will be able to name four specific disease states where the authors note TPN should be the first choice for nutrition support and why this is so.

TPN has recently come under review for its role in home-based nutritional therapy.

The role of TPN in nutrition therapy has been significant. The advent of home care introduced a new way of treating patients that outlined an active patient care role for the patients themselves and their families. When the reimbursement landscape began changing in the eighties, this left an even larger role for patients and their families. Some of the care that used to be performed by a clinician was now the burden of those back home. 

Enteral therapy's benefits (perceived ease-of-use and cost-savings) combined with TPN's early widespread acceptance, has led to TPN's decrease in popularity in recent years.  What was once viewed as the cutting edge of nutritional therapy with its ability to feed patients where other methods (enteral feeding) had failed, TPN's reputation began to suffer with reports of catheter-related sepsis, bacterial translocation, mucosal atrophy and outright gut failure. Retrospective analysis now reveals that TPN's reputation has possibly suffered more from overfeeding and inadequate patient education and care, than it has from the physical complications of parenteral feeding.

The purpose of this journal club is to look at the literature and make an analysis of TPN's safety and efficacy in today's environment, primarily as it relates to nutritional support in the home setting. Another aspect is its role in nutritional support. The where, when and why of using TPN in a largely enteral-biased environment. Where does TPN fit in? How has the role of TPN changed in the treatment of patients with gut failure, and how is it used in partnership with enteral feeds?  Three studies, two from gastroenterological journals and one from a medical nutrition journal, all well-referenced and written by respected authors, examine these topics for our journal club. Our journal club author then makes her own conclusions about their findings, as a way of bringing the results into sharper focus.

Click on the link at left to go to your desired page:  Page 1  Page 2  Page 3  Page 4  Page 5  Post-Test

Continue on to Study 1

2002 Hi-R-Ed Online University. All courses posted on this site are the property of Hi-R-Ed Online University unless otherwise stated. Courses may not be copied or transferred in electronic, printed, or other forms, or modified for any purpose without explicit written consent of Hi-R-Ed Online University.