Administering Parenteral Nutrition Through a Central Line

Summary

This video script provides detailed instructions on how to safely administer Central Parenteral Nutrition (CPN). It emphasizes patient privacy, hand hygiene, and the use of strict aseptic techniques. Key steps include verifying patient identity, checking solution compatibility, ensuring proper labeling, and handling the infusion tubing. The script also covers guidelines for setting the infusion rate, using separate lines for medications or blood transfusions, and managing patient care without interrupting CPN administration. The procedure concludes with documenting the patient's tolerance and performing hand hygiene after completing the care.

Takeaways

• 😀 Always perform hand hygiene and ensure patient privacy before beginning patient care.
• 😀 Identify the patient using two identifiers (name and date of birth) before administering Central Parenteral Nutrition (CPN).
• 😀 Follow strict aseptic techniques during infusion tubing and filter changes, replacing them every 24 hours or immediately if contaminated.
• 😀 Double-check the healthcare provider’s orders against the Medication Administration Record (MAR) to confirm the correct solution and labeling.
• 😀 Verify that the CPN solution contains the correct additives and has not expired, including amino acids, glucose, lipids, electrolytes, vitamins, and trace elements.
• 😀 Inspect the CPN solution for particulate matter or separation before use, especially for two-to-one or three-to-one solutions.
• 😀 Always perform hand hygiene, wear gloves, and attach the appropriate filter to the IV tubing, priming it with the CPN solution to remove air bubbles.
• 😀 Use an alcohol swab to clean the correct port before connecting the tubing to the central catheter port.
• 😀 Adjust the flow rate using the infusion pump, and refer to agency policy to determine the initial rate and gradual increase if necessary.
• 😀 CPN access should be used only for nutritional purposes; use separate lines for other treatments such as medications or blood transfusions.
• 😀 Never interrupt the CPN infusion for routine procedures like patient transport, showers, or blood transfusions, unless absolutely necessary.
• 😀 After completing the procedure, discard used supplies, document the patient's tolerance, and perform hand hygiene before leaving the room.

Q & A

What is the first step in administering Central Parenteral Nutrition (CPN)?

The first step is to always perform hand hygiene and provide patient privacy before beginning patient care.

How do you identify the patient before administering CPN?

You identify the patient using two identifiers, which typically include asking for their name and date of birth.

What technique must be followed when infusing tubing and changing filters for CPN?

Strict aseptic technique must be followed during infusion tubing and filter changes.

How often should the tubing and filter components be replaced?

The tubing and filter components should be replaced every 24 hours or immediately if contamination is suspected.

What should be checked before administering CPN solution?

Before administering CPN, you should compare the healthcare provider's orders with the Medication Administration Record (MAR) to ensure the correct solution is used and properly labeled.

What is the role of inspecting the CPN solution?

You should inspect the CPN solution for particulate matter if it's a two-to-one solution or separation if it's a three-to-one solution.

What should be done with the IV tubing before connecting it to the catheter?

The IV tubing should be primed with the CPN solution, ensuring no air bubbles remain. Allow the solution to run into the trash receptacle to clear the line before connecting it.

What is the correct action when connecting the CPN tubing to the central catheter?

Once the tubing is primed, you should connect the end of the tubing to the appropriate central catheter port and label it.

How should the infusion rate be set for CPN?

The infusion rate should be initially set to a rate that maintains the patency of the line. Depending on the agency's policy, the rate may be gradually increased to meet the patient's nutritional needs.

What precautions should be taken if the patient needs other IV medications or blood transfusions?

CPN access should be used only for its intended purpose. If the patient needs IV medications or blood, they should be administered through a separate line or lumen. Routine procedures, such as showers or blood transfusions, should not interrupt the CPN infusion.