Name of the Procedure:

Common Name(s): Home Infusion Therapy, TPN
Medical Term: Total Parenteral Nutrition (TPN) Home Infusion

Summary

Home infusion therapy involves administering nutrients directly into the bloodstream through a vein. This is done for patients who cannot eat or absorb enough nutrients through regular oral intake. TPN provides these essential nutrients, delivered at home, minimizing hospital stays and improving quality of life.

Purpose

Medical Conditions or Problems Addressed:

• Severe gastrointestinal disorders
• Malabsorption syndromes
• Chronic illness causing malnutrition

Goals or Expected Outcomes:

• Ensure adequate nutritional intake
• Maintain or improve nutritional status
• Reduce hospital admission frequency

Indications

Specific Symptoms or Conditions:

• Inability to ingest or absorb food orally
• Severe digestive disorders (e.g., Crohn's disease, bowel obstructions)

Patient Criteria:

• Medically stable to be treated at home
• Must have a suitable venous access device (e.g., central line, PICC line)

Preparation

Pre-Procedure Instructions:

• Initial assessment by a healthcare professional
• Blood tests to determine baseline nutritional status
• Training on the use of infusion equipment and care of vascular access

Procedure Description

Detailed Steps:

1. Assessment: Health professional evaluates patient's nutritional needs.
2. Prescription: Custom TPN formula is prescribed by the physician.
3. Setup at Home: Pharmacy prepares TPN solution. Home health nurse sets up the infusion pump and educates the patient/caregivers.
4. Infusion: Patient connects TPN bag to their catheter, usually administered over a period of 10-12 hours daily.

Tools/Equipment:

• Infusion pump
• TPN solution bag
• Vascular access device (e.g., central line, PICC line)
• Sterile supplies for handling

Anesthesia/Sedation:

• Not typically required

Duration

Time Needed:

• Daily infusions usually last between 10-12 hours

Setting

Location:

• Patient's home with periodic visits by healthcare professionals

Personnel

Healthcare Professionals Involved:

• Pharmacists
• Home health nurses
• Dietitians
• Physicians

Risks and Complications

Common Risks:

• Infection at catheter site
• Hyperglycemia or electrolyte imbalances

Rare Risks:

• Liver dysfunction
• Venous thrombosis

Management:

• Regular monitoring of blood tests
• Immediate medical attention for signs of infection

Benefits

Expected Benefits:

• Nutritional support tailored to individual needs
• Improved energy levels and overall health
• Ability to maintain normal daily routines

Realization Timeline:

• Benefits usually noticeable within a few days to weeks

Recovery

Post-Procedure Care:

• Regular cleanings and maintenance of infusion equipment
• Follow-up visits with healthcare team

Recovery Time:

• Continuous treatment with periodic reassessment

Restrictions:

• Maintain aseptic techniques to prevent infections

Alternatives

Other Treatment Options:

• Enteral nutrition (tube feeding)
• Oral nutritional supplements

Pros and Cons:

• Enteral Nutrition: Less invasive but not suitable for severe gut malfunctions.
• Oral Supplements: Easier for patient, but often inadequate for severe conditions.

Patient Experience

During Procedure:

• Mild discomfort during line insertion
• Routine daily task of connecting/disconnecting infusion

After Procedure:

• Vigilance for signs of infection
• Regular activities can generally be maintained

Pain Management:

• Over-the-counter pain relief if any discomfort arises from catheter site