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Application of quality improvement techniques to reduce parenteral nutrition wastage in a national intestinal failure unit. | LitMetric

AI Article Synopsis

  • A quality improvement project aimed to reduce parenteral nutrition (PN) wastage by 10% over 9 months at a national intestinal failure unit (IFU) since PN can cost around £80 per day and is often wasted due to various clinical reasons!* -
  • The team utilized methods like pareto charts and PDSA cycles to identify and address the causes of waste, focusing on clinical awareness, efficient bag redistribution, stock rotations, and improved discharge planning!* -
  • As a result of these interventions, the project achieved a 34% reduction in PN wastage, leading to significant cost savings of approximately £30,000 per year in a high-use clinical setting!*

Article Abstract

Objectives: Parenteral nutrition (PN) costs approximately £80 per day per bag. Unpredictable changes in patients' clinical condition, venous access loss or reasons related to the processes involved in administering PN can lead to PN wastage. Cost efficiencies are imperative to optimise limited resource utilisation in all current healthcare economies. We undertook a quality improvement (QI) project to reduce PN wastage in an adult acute hospital setting. The project SMART's (specific, measurable, achievable, realistic, time-based) objective was reducing in-patient PN wastage by 10% in 9 months using QI methodology on a national intestinal failure unit (IFU).

Method: Wastage reasons were evaluated through pareto charts to target waste reduction using 'Plan, Do, Study, Act' (PDSA) cycles. Variation was mapped using c-charts.

Results: 12-week baseline wastage data predicted 1000 bags wasted per annum (p.a.). PDSA cycles actioned included: regular enhanced clinical team awareness of wastage; unused PN bags redistributed within expiry date; stock bag rotation; critical path analysis of PN bag journey; enhanced discharge planning/coordination; reorganisation of fridge PN storage according to weekday; changing ordering frequency and bag type (from tailored to standard) to increase flexibility around discharge date and PN weaning. Implementation of PDSA cycles led to a 34% reduction in PN wastage in 9 months.

Conclusion: In a high-use IFU, PN wastage is common and costly. Using a QI approach with concurrent PDSA cycles and a motivated multidisciplinary team, high levels of wastage reduction are possible with associated significant cost savings and from this study a predicted cost saving of approximately £30 000 p.a.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452361PMC
http://dx.doi.org/10.1136/ejhpharm-2016-001197DOI Listing

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