5PSQ-018 Implementation of parenteral nutrition prescribing software in a neonatal intensive care unit

2019 
Background Parenteral nutrition in neonatal intensive care units is a daily activity with extreme risks. These risks are mainly related to the immaturity of neonates, a sensitive population. The computerisation of the process of prescription is a promotional tool to reduce the risks. Purpose This study aimed to assess the interest in implementing software to help prescribers of parenteral nutrition in neonatology. Material and methods This prospective comparative study was conducted in a neonatal unit, during a period of 3 months. It looked to evaluate the process of preparation of parenteral nutrition mixtures before and after the implementation of the prescribing software. This software was developed and validated by a team of doctors and pharmacists. The evaluation was performed by making a comparison between the errors that occurred during the manual prescribing phase and those that occurred during the computerised phase. All steps of the process were assessed using a data collection sheet. Statistical analysis was performed by PSPP software. Results Fifty pockets of parenteral nutrition were examined during both phases. This study showed a statistically significant improvement in considering both the sodium and fluid intake of the other drugs prescribed with: OR=0.40, 95% CI: 0.30 to 0.58, p 3 , respectively. Regarding the preparation step, the order of components introduced was significantly better when using the software: OR=0.12, 95% CI: 0.04 to 0.35), p 3 . The labelling was significantly more respected with computerisation: OR=0.22, 95% CI: 0.06 to 0.74, p=0.017. No impact was detected in the transcription step when using the software with: OR=1.53, 95% CI: 0.53 to 4.42, p=0.424. Likewise, no impact was detected in the administration step with: OR=0.49, 95% CI: 0.04 to 5.58, p=1. Conclusion The implementation of the prescribing software was beneficial in terms of error management, time and traceability. The computerisation of the process, from the prescription to the administration, is necessary to guarantee security and efficiency in the neonatal intensive care unit. Thus, it is recommended to generalise this pilot experiment in the interests of both prescribers and patients. References and/or acknowledgements https://onlinelibrary.wiley.com/doi/full/10.1111/jpc.14139 https://www.ncbi.nlm.nih.gov/pubmed/15060223 No conflict of interest.
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