Cost Saving and Opinion/Satisfaction of Total Parenteral Nutrition (TPN) admixture Service for neonate at Pharmacy Department, Sisaket Hospital

Abstract

Objective study: To assess the outcomes of TPN admixture service at Pharmacy Department, Sisaket Hospital.
Study Design: Retrospective descriptive study
Method: TPN preparation records from August 2004 to 30 September 2005 were collected to assess amount of work and the cost of additives used for TPN preparation. The cost of TPN solutions prepared under laminar air flow hood at Pharmacy department (which remained additives can keep for later use) was compared with those of TPN solutions when calculated in condition of prepared at patient ward (remained additives must discarded to avoid contamination). The satisfaction of medical staffs in TPN admixture service was determined by questionnaire.
Results: Preparation of TPN for neonate at NICU ward from August 2004 to 30 September 2005 was 759 times in 141 patients. The cost of TPN solutions prepared by Pharmacy department was 136,575.29 baht while cost of TPN solutions prepared at patient ward was 256,862.29 baht; cost saving from preparing TPN at Pharmacy department was 120,264 baht (46.82% reduction). The physicians and nurses of NICU ward had 100% satisfaction in TPN admixture service. Nursing staffs were satisfied in reason of work load reduction. Physicians had convenience in TPN ordering because of pharmacist role in TPN admixture calculation and anticipate risk of precipitation. Most medical staff realized role of pharmacist in TPN preparation. Furthermore they had agreed that the service should be extend to pediatric patients and cover for holidays.
Conclusion: According to the study, TPN admixture service by Pharmacy department reduced cost of preparation, reduced nursing staff’s work load. Physician had convenience to order TPN and satisfied with pharmacist role in risk of precipitation checking. So pharmacists made clearly benefits in TPN admixture service and became the acceptance role by medical team. Most of medical staffs also required pharmacist to provide follow up care to patients in addition of admixture preparation.