ASPEN Parenteral Nutrition Care Pathway

This patient care pathway provides steps and online resources — from initial assessment of need to transition to home — for patients who may require parenteral nutrition (PN). Click on resources to pull up documents, checklists, and websites. Please note that, though the majority of these materials are open-source, some require a subscription in order to obtain access to full journal articles.

This pathway was developed by the ASPEN PN Safety Committee.

Overview of Pathway

Click on a title in the pathway below to jump directly to that section.

Parenteral Nutrition Care Pathway

The steps outlined below are intended to promote the clinical benefits and minimize the risks associated with PN.

Determine PN Appropriateness
Determine if patient is an appropriate candidate for PN
Assess Venous Catheter Status and Insert Appropriate Venous Access
Prescribe PN Correctly Using Standardized Process
Use Computerized Provider Order Entry (CPOE) when able
Use Clinical Decision Support tools
Transmit PN Order to Pharmacy
Communicate PN prescription to pharmacy using electronic means with minimal transcription
Pharmacist Reviews and Verifies PN Order
Clinical review
Pharmacologic review
Communication and order modification with prescriber as needed
Initiate Discharge Planning for Transition of Care as Appropriate
Verify insurance coverage and identify home infusion provider
Educate patient and caregivers on home PN and supports
Identify prescriber
Communicate discharge PN order, labs, frequency and monitoring parameters to home infusion company
Parenteral Nutrition Quality Improvement Program
Develop error reporting program
Implement infection control for CLABSI
Monitor appropriate PN use
Maintain glucose control
Monitor readmissions of home PN patients