Utilization of a Standardized Discharge Checklist to Improve the Transition of Care for Patients Receiving Parenteral Nutrition

Document Type

Article

Publication Date

10-9-2020

Publication Title

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

Keywords

Checklist, Humans, Parenteral Nutrition, Patient Discharge, Patient Transfer, Retrospective Studies, checklist, home parenteral nutrition, hospital readmission, length of stay, patient discharge

Abstract

BACKGROUND: Guidelines recommend using discharge checklists to discharge patients receiving parenteral nutrition (PN). Transition-of-care (TOC) tools have not been extensively studied in the PN population. The purpose of this study is to evaluate the impact of a standardized PN discharge checklist on TOC for PN patients.

METHODS: This is an Institutional Review Board-approved, retrospective quasi-experimental study of patients discharged receiving PN between January 1, 2014, and May 31, 2018. The primary end point was the completion of a PN discharge bundle (identification of a responsible provider to monitor PN after discharge, meeting daily caloric requirement of 20-35 kcal/kg/d, cycling PN prior to discharge). Secondary end points included documentation of PN discharge checklist components, hospital length of stay, frequency of 30-day hospital encounters, cause of hospital encounters, and time to readmission.

RESULTS: Fifty encounters were included in the pregroup and postgroup each (n = 100). There was a significant increase in completion of the TOC bundle in the postgroup (54% vs 76%, P = .035), driven by identification of a responsible provider for outpatient PN management (54% vs 82%, P = .005). Other PN discharge checklist components impacted included the following: case manager had the PN prescription for home infusion (50% vs 80%, P = .003), assessment for home glucometer (40% vs 90%, P < .001), and PN plan-of-care note documentation at discharge (18% vs 82%, P < .001).

CONCLUSIONS: A standardized PN discharge checklist improved completion of discharge bundle.

Medical Subject Headings

Checklist; Humans; Parenteral Nutrition; Patient Discharge; Patient Transfer; Retrospective Studies; checklist; home parenteral nutrition; hospital readmission; length of stay; patient discharge

PubMed ID

33037705

ePublication

ePub ahead of print

Volume

36

Issue

4

First Page

877

Last Page

883

Find It @ Sladen

Share

COinS