ASPEN Best Practices in Parenteral Nutrition Training Series

Four-Part Live Webinar Series Starting May 20

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risks for adverse events. Complications can occur as a result of the therapy and as the result of the PN process. These consensus recommendations are based on practices that are generally accepted to minimize errors with PN therapy, categorized in the areas of PN prescribing, order review and verification, compounding, and administration. These recommendations should be used in conjunction with other ASPEN publications, and researchers should consider studying the questions brought forth in this document.

Phil Ayers, Stephen Adams, Joseph Boullata, Jane Gervasio, Beverly Holcombe, Michael D. Kraft, Neil Marshall, Antoinette Neal, Gordon Sacks, David S. Seres and Patricia Worthington. ASPEN Parenteral Nutrition Safety Consensus Recommendations. JPEN J Parenter Enteral Nutr, 38:3, 296-333. (2014)

Since the release of these recommendations, ASPEN has published numerous papers as part of the organization’s efforts to ensure clinicians have the resources necessary for safe PN practices. These resources include:

  • ASPEN Clinical Guidelines: Parenteral Nutrition Ordering, Order Review, Compounding, Labeling, and Dispensing. JPEN J Parenter Enteral Nutr, 38:3, 334-377. (2014)
  • Standardized Competencies for Parenteral Nutrition Prescribing: The American Society for Parenteral and Enteral Nutrition Model. NCP Nutr Clin Pract, 30:4, 570-576. (2016)
  • Standardized Competencies for Parenteral Nutrition Order Review and Parenteral Nutrition Preparation, Including Compounding: The ASPEN Model. NCP Nutr Clin Pract, 31:4, 548-555. (2016)
  • When is Parenteral Nutrition Appropriate? JPEN J Parenter Enteral Nutr, 41:3, 324-377. (2017)
  • Parenteral Nutrition Errors and Potential Errors Reported Over the Past 10 years. NCP Nutr Clin Pract, 32:6, 826-830. (2017)
  • Standardized Competencies for Parenteral Nutrition Administration: The ASPEN Model. NCP Nutr Clin Pract, 33:2, 295-304. (2018)

While access to the papers is widely available, the ability for the clinician to integrate the information in practice may be limited. As a solution to this, ASPEN is launching a new Parenteral Nutrition Safety Series that encompasses information from the above-mentioned resources with practical application recommendations for the clinicians in practice. This training series will be in a webinar format and consist of four interwoven parts. As a participant in the training series you have the option to participate in one or all parts. However, because of the complexities associated with PN safety, ASPEN recommends participation in the entire series for all members of the healthcare team involved in providing PN to patients in all settings. The four parts are as follows.




Part 1: Prescribing the Parenteral Nutrition (PN) Order and Beyond
 Register for Part 1    Register for the 4-Part Series

Date: May 20, 2020                   
Time: 3:30 - 5:00 PM ET 

Learning Objectives

  1. Describe some fundamental rules that can minimize the risk of an incompatible or unstable admixture when making recommendations or ordering parenteral nutrition
  2. Outline PN Prescribing within the Competency Framework
  3. Describe the elements in ASPEN PN Ordering Writing Competency Assessment Checklist
  4. Identify credible resources to support parenteral nutrition (PN) prescribing best practices during and after product shortages.
  5. Identify best practices for PN prescribing that are commonly overlooked due to recurrent PN component shortages.

Faculty and Topics
Competencies in Prescribing the PN Order
Peggi Guenter, PhD, RN, FAAN, FASPEN, Senior Director, Clinical Practice, Quality, and Advocacy, American Society for Parenteral and Enteral Nutrition, Silver Spring, MD

PN Compatibility and Stability Basics: Get Ready to Prescribe PN
Joseph Boullata, PharmD, RPh, CNS-S, FASPEN, FACN, Pharmacy Specialist, Clinical Nutrition Support Services, Hospital of the University of Pennsylvania, Philadelphia, PA 

Prescribing PN in an Environment of Drug Shortages
Beverly Holcombe, PharmD, BCNSP, Clinical Practice Specialist, American Society for Parenteral and Enteral Nutrition, Silver Spring, MD

Moderator
Jessica Monczka, RD, LDN, CNSC

CE Credit: 1.5 hours                                        
UAN: JA0002345-0000-20-092-L04-P 
Level: Intermediate


Part 2: Reviewing and Verifying the Parenteral Nutrition Order

 Register for Part 2    Register for the 4-Part Series

Date: May 27, 2020                   
Time: 3:30 - 5:00 PM ET 

Learning Objectives

  1. Describe methods to ensure competency of pharmacists reviewing and verifying parenteral nutrition
  2. List key ASPEN PN Safety Recommendations regarding Parenteral Nutrition (PN) order review and verification
  3. Describe ways technology and clinical decision support can be integrated to improve PN safety during order review and verification

Faculty and Topics
Assuring Competency for Reviewing and Verifying Parenteral Nutrition
Phil Ayers, PharmD, BCNSP, FASHP, Chief, Clinical Pharmacy Services, Mississippi Baptist Health Systems; Clinical Associate Professor, University of Mississippi, Jackson, MS

Parenteral Nutrition Order Verification: Optimizing Safety and Integrating Technology
Michael Kraft, PharmD, BCNSP, Clinical Associate Professor, Department of Clinical Pharmacy, University of Michigan College of Pharmacy; Assistant Director of Pharmacy — Education and Research, University of Michigan Hospitals and Health Center, Ann Arbor, MI

Moderator
Sarah Vest Cogle, PharmD, BCCCP, Assistant Clinical Professor, Auburn University Harrison School of Pharmacy, Clinical Pharmacist, Critical Care/Nutrition Support, East Alabama Medical Center, Auburn, AL

CE Credit: 1.5 hours                                          
UAN: JA0002345-0000-20-093-L04-P  
Level: Intermediate


Part 3: Compounding Parenteral Nutrition Admixtures

 Register for Part 3    Register for the 4-Part Series

Date: June 4, 2020                                                   
Time: 3:00 - 4:30 PM ET    

Learning Objectives

  1. Determine the stability/compatibility of additives to PN based on established criteria
  2. Evaluate calcium and phosphate compatibility in a PN solution
  3. Describe the criteria to evaluate lipid stability in parenteral nutrition admixtures
  4. Describe the limitations of typical pediatric PN formulations as they relate to total nutrient admixture
  5. Discuss what excipients should be avoided when compounding a PN for a neonat
  6. Summarize potential incompatibilities when combining additives and discuss how automated compounding devices (ACDs) can help prevent the
  7. Discuss ways of avoiding errors by integrating ACDs into your workflow

Faculty and Topics
Methods to Evaluate Stability and Compatibility in PN 

Mark Klang, MS, RPh, BCNSP, PhD, Core Lab Manager, Research Pharmacy, Memorial Sloan Kettering Cancer Center; Associate Professor, Arnold and Marie College of Pharmacy, New York, NY 

Special Topics in PN Compounding
Kathleen Gura, PharmD, BCNSP, FASHP, FPPAG, Pharmacy Clinical Research Program Manager, Boston Children's Hospital; Assistant Professor of Pediatrics, Harvard Medical School, Boston, MA

Moderator
Jane Hughes, PharmD, BCNSP, BC-ADM, Clinical Pharmacist, VA Boston Healthcare System, Boston, MA

CE Credit: 1.5 hours
UAN: JA0002345-0000-20-094-L04-P
Level: Intermediate



Part 4: Administering Parenteral Nutrition

 Register for Part 4    Register for the 4-Part Series

Date: June 11, 2020                   
Time: 1:00 - 2:30 PM ET 

Learning Objectives

  1. Describe the most likely errors associated with administering parenteral nutrition in various patient populations and settings
  2. Identify strategies to institute to prevent errors when administering parenteral nutrition in various patient populations and settings
  3. Recognize the role of inline filters in promoting patient safety during PN therapy

Faculty and Topics
Patricia Worthington, MS, RN, CNSC, Nutrition Support Nurse, Jefferson University Hospitals, Philadelphia, PA

Mary Gallotto, BSN, RD, Staff Nurse, Home Parenteral Nutrition Program, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children’s Hospital, Boston, MA

Jennifer McClelland, BSN, MS, RN, FNP-BC, Nurse Practitioner, Home Parenteral Nutrition Program, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children’s Hospital, Boston, MA

Moderator
Liz Page RDN, CNSC, LDN, Clinical Nutrition Manager, Baptist Medical Center, Wolfson Children’s Hospital & Baptist MD Anderson Cancer Center, Jacksonville, FL

CE Credit: 1.5 hours                                          
UAN: JA0002345-0000-20-095-L04-P  
Level: Intermediate