Order TPN For Neonates/Pediatrics

• If you haven't already, open the TPN order form:

1. Select the patient.

2. Click Write (ALT+W).

3. If prompted, record the actual or estimated weight of the patient.

An actual or estimated weight is required for parenteral nutrition orders. You cannot open the order form unless there is a weight on record.

4. Click TPN (ALT+T).

5. Click Add (ALT+A).

6. If prompted, click an option to choose a weight for calculations: weight used for previous active TPN order, or most recent weight on file. Click OK.

• Information on the order:

• Pediatric/neonatal TPN parameters are automatically utilized for patients weighing less than 40 kg.

• For MGH Pediatric TPN Guidelines, click More Info. Click OK to return to the order form.

• If an active order for TPN exists, the new order form is populated with its values automatically. However, if you chose to change the weight for calculations when prompted, the volume and rate fields are reset to no entry.

• The Total Daily Fluids displayed is a general care order. See Fluid Management Orders.

• Complete the form:

1. Indicate the volumes, rate, and route

2. Order amino acids, dextrose, and fats

3. Order additives

4. Type instructions as needed.

5. Select a start time (9pm on any day within one week).

6. Click OK (ALT+O).

7. 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.