Utilization of a standardized discharge checklist to improve the transition of care for patients receiving parenteral nutrition

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...

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Bibliographic Details
Published in:Nutrition in clinical practice 2021-08, Vol.36 (4), p.877-883
Main Authors: Doh, Jean, Hencken, Laura, Mlynarek, Linda, MacDonald, Nancy
Format: Article
Language:English
Subjects:
checklist
home parenteral nutrition
hospital readmission
length of stay
Nursing
parenteral nutrition
patient discharge
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Summary: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.
ISSN:0884-5336
1941-2452
DOI:10.1002/ncp.10580