You must have specific authorization to write TPN orders for adult patients.
Adult TPN parameters are automatically utilized for pediatric patients weighing more than 40 kg.
Complete the form:
Set the infusion rate:
Single rate—For the patient's initial TPN order, the rate defaults to 45 ml/hr. If needed, type the rate of infusion and press TAB.
Cycling rates—The Rate of Infusion field must be cleared to define multiple rates; delete any number entered here. Click Cycling Rates (ALT+Y). Type the ml/hr and duration for each cycle, totaling 24 hrs. Click OK (ALT+O).
POE calculates the total 24-hour volume for the rates entered.
Click Central or Peripheral to select a route.
Click Solution Type (ALT+S).
Click to select a TPN Solution. Option availability is based on the administration route.
For Non-Standard solutions, press TAB and type the values for protein, dextrose, and fat. KCal/L calculates automatically from this information.
Select an amino acid solution.
Click OK (ALT+O).
When prompted, set amounts for additives. The Multivitamins (MVI) and Trace element amounts are preset to recommended levels.
Type the concentration or volume of each additive as needed.
If needed, click Optional Additives (ALT+A). Type the amount of each additive, then click OK (ALT+O).
Click OK (ALT+O) to return to the TPN order form.
To change your selections, click Additives (ALT+A).
Select a start time ( 9pm on any day within one week).
Type instructions as needed.
Click OK (ALT+O).
When prompted, include associated orders as needed. See Consequent Orders for more information.
Orders written for peripheral administration are described as Peripheral Parenteral Nutrition (PPN).
Write additional orders as needed, then sign the session.