TPN in LTC/Rehab

[kyliebear]

Has anyone ever heard of having TPN in LTC or has anyone dc'd a pt to a LTC with TPN? Personally I think the fifteen minute inservice we got is an acident waiting to happen. No one where I work has a clue about it. He was a res and went out to the hospital and was stable enough for transfer but not stable enough for surgery. If anyone has any tips for me that would be great. thanks.....

[Inquisitive one]

We've had TPN at the LTC facility I work at. Not often though. Things that come to mind immediately are: Daily weights, I&0, Accuchecks every 6 hours with sliding scale insulin, frequent labs, 2 nurses need to compare TPN and additives against orders before hanging, change bag and tubing with filter every 24 hours, use a 1.2 micron filter, if adding additives- use strict sterile technique and preferably and RN should add (check with your facilities policy about LPN's handling TPN), PICC line or central line used with a designated port for TPN only, if TPN needs to be stopped you must hang dextrose 10% at the same rate the TPN was running at - so always have a bag or 2 available, respiratory assessment at least every shift, vital signs at least every shift sometimes temp more often.

[TheCommuter, BSN, RN]

We have the occasional patient with TPN at the LTCF where I work.

Since I am an LVN, I am not allowed to touch TPN. I need to track down an RN to start, stop, and clean it.