Ok, so question about TPN. I recently started at a new hospital in a new state, and I am always shocked out how things are so "slap happy" at this new hospital, but this hospital is the biggest one in the city, so they can do things thier own way, but anyways. I am always taught during nursing school
, nearly 3 years out, and at a hospital I used to work at, when initiating TPN (with or without lipids), you needed a central line (TLC or PICC), and that thier had to be a "virgin port", or a port never used for any med, electrolyes, abx, absolutely nothing. And if you had a central line before TPN started, that it had to be changed over guide wire, or a new site, or else a new PICC. So at the new hospital, I was told that I was crazy when I asked this question when I got new orders to start TPN. So the question is, what is the policy regarding TPN at your hospitals across the USA? We started new lines to decrease central line infections since TPN is so "sugary" and a perfect environment for infection.
Sep 4, '06
It's been awhile since I've given TPN (since I work ER), but I've never worked anywhere that would allow TPN to be infused in anything but a central line. Some places administer PPN (peripheral parenteral nutrition) via peripheral IV. Most places have policies governing the max % of dextrose that can be infused peripherally, check the policy and procedure book of your institution.
Never heard of having to have a new line, have infused TPN to pts who had lines for years!!
Last edit by Pedi-ER-RN on Sep 4, '06