Clinical practice guidelineAuSPEN clinical practice guideline for home parenteral nutrition patients in Australia and New Zealand
Section snippets
Objective
The objective is to provide evidence-based clinical practice guidelines for feeding adults intravenously at home or in the community when they have intestinal failure (IF) and are unable to meet oral nutritional and fluid requirements. This is commonly known as home parenteral nutrition (HPN). These guidelines have been written to support all health care professionals involved with the care of patients referred for HPN.
Aims
- 1
The guidelines will be factually up-to-date and reflect current, evidence-based best-practice HPN.
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The guidelines will aid nutritional support (NS) personnel in their use of evidence-based recommendations to improve clinical and professional practices for HPN in Australia and New Zealand.
- 3
The guidelines will serve as a tool to help policy makers, health care organizations, and NS professionals to allocate sufficient resources to deliver safe and appropriate HPN in Australia and New Zealand.
Methods
A multidisciplinary working party of Australia and New Zealand health professionals with extensive experience in the provision of HPN was convened in 2005. This working party consisted of doctors, dietitians, pharmacists, scientists, and nurses and was later formalized into the AuSPEN HPN Guideline Development Group (GDG).
The GDG held three formal meetings and communicated regularly by e-mail and telephone. A consensus approach was used to develop the guideline. A separate pediatric working
Search strategy
Seven existing guidelines identified from our literature search that contained material relating to PN were appraised using a validated instrument (AGREE) for evaluation of clinical practice guidelines.
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The National Institute for Health & Clinical Excellence (NICE) Nutrition Support in Adults [11]
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The American Society of Parenteral and Enteral Nutrition (ASPEN) Nutrition Support in Clinical Practice: review of published data and recommendations for future research directions [12]
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ASPEN Guidelines
Clinical and practical questions for HPN
Ten clinical questions were identified for inclusion in the AuSPEN HPN guideline. Each question is answered by reviews of the evidence and summaries of the GDG discussion, and a final recommendation is made (summarized in Appendix).
- 1
What are the criteria for selection for an HPN program?
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How should patients be trained for HPN?
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Who should provide care for patients on HPN?
- 4
How should CVCs for HPN be selected and placed?
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How should HPN prescriptions be formulated and provided?
- 6
How should infusion pumps
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Cited by (0)
The Australasian Society of Parenteral and Enteral Nutrition provided travel assistance to Guideline Development Group (GDG) members to attend one GDG meeting. No member of the GDG received financial support from any commercial provider of home parenteral nutrition other than expenses for educational lectures. Industry representatives from Baxter Healthcare Pty Ltd., a provider company, gave travel assistance to some members of the GDG and provided a meeting room for the initial meeting but thereafter were not part of the GDG. All authors comprised the GDG.