Page 62 - policy and procedure infection control

Policies and Procedures on Infection Control

4.5 Parenteral Nutrition

4.5.1 Introduction

Infectious-related complications may be a major threat to patient receiving centrally infused
parenteral nutrition (PN). In many cases, these patients are predisposed to infections
because of compromised immunity or infections located in the urinary tract, lungs or
wounds. However, infections may develop consequent to solution contamination during
preparation. This may be due to a lack of aseptic technique.

should only be use when clinically indicated and the line must not remain inside longer
than necessary Because PN solution is a good medium for bacteria growth and its
administration through central venous line gives systemic access, complications such
as contamination, infection and sepsis are possible risks.

PN differs from other modes of intravascular therapy in many ways:
 PN tubing usually remain in place much longer than most other catheters
 PN solutions support the growth of microorganisms, especially gram-negative bacteria
and Candida sp.

 The underlying disease of the patient increases the risk of acquiring HCAIs.

Contamination can occur during:
 Preparation of PN
 Insertion of catheter
 Manipulation of catheter
 Prolonged hanging time
Assembling of PN tubing must be under strict aseptic technique.

4.5.2 Preparation of PN

 Prepare PN strictly under aseptic technique and clean room environment.
 Only trained staffs are allowed to do the compounding.
 All qualified staff is required to wear Personnel Protective Equipments (PPE) before
they enter the clean room.

4.5.3. Catheter care-related factors (refer to section intravascular line)
1. Selection of catheter insertion site
 Use a single lumen catheter unless multiple ports are essential for the management
of the patient.

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