Performance Model Anchors Successful Nutrition Support Protocol

Parenteral nutrition (PN) has been identified as a potentially high risk and costly drug therapy that tends to be overused. A continuous quality improvement (CQI) model, FOCUS-PDCA, provided the framework used by our Total Parenteral Nutrition (TPN) Subcommittee to develop processes that reduced inappropriate use of PN, improved the quality of patient care, and reduced costs. Through the application of this process from 1992 to 1996, the use of TPN was reduced by 52%, and a 95% appropriateness level was achieved. The success of this methodology also was reflected, during 1996, in an increased use of enteral nutrition, which peaked to 112% from the initial 1995 baseline measurement and in estimated cost savings of $226,184 from reduced use of TPN. Our experience suggests that patients benefit from an improved nutrition screening and assessment program combined with monitoring and education. Achievement of quality nutrition care is cost effective and can be sustained through a nutrition support protocol tha...