Total parenteral nutrition: how to reduce the risks.

Total parenteral nutrition has a number of associated complications. These include air embolism and haemothorax on insertion of the line, infection, catheter blockage, catheter-related sepsis and thrombotic obstruction. A nurse-led initiative was undertaken to improve the administration of TPN through the development of evidence-based practice. The aims were to keep the catheter free from infection and blockage, with an uninterrupted feeding period, irrespective of length of time. A study of 235 episodes of feeding over two years showed a marked reduction in complications, and resulted in a dedicated unit for patients requiring TPN.