Katoue Maram Gamal, Al-Taweel Dalal, Matar Kamal Mohamed, Kombian Samuel B
Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Kuwait.
Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait.
Int J Health Care Qual Assur. 2016 Jul 11;29(6):664-74. doi: 10.1108/IJHCQA-08-2015-0104.
Purpose - The purpose of this paper is to explore parenteral nutrition (PN) practices in hospital pharmacies of Kuwait and identify potential avenues for quality improvement in this service. Design/methodology/approach - A descriptive, qualitative study about PN practices was conducted from June 2012 to February 2013 in Kuwait. Data were collected via in-depth semi-structured interviews with the head total parenteral nutrition (TPN) pharmacists at seven hospitals using a developed questionnaire. The questionnaire obtained information about the PN service at each hospital including the existence of nutritional support teams (NSTs), PN preparation practices, quality controls and guidelines/protocols. The interviews were audio-recorded, transcribed verbatim and analyzed for content. Findings - Seven hospitals in Kuwait provided PN preparation service through TPN units within hospital pharmacies. Functional NSTs did not exist in any of these hospitals. All TPN units used paper-based standard PN order forms for requesting PN. The content of PN order forms and PN formulas labeling information were inconsistent across hospitals. Most of the prepared PN formulas were tailor-made and packed in single compartment bags. Quality controls used included gravimetric analysis and visual inspection of PN formulations, and less consistently reported periodic evaluation of the aseptic techniques. Six TPN units independently developed PN guidelines/protocols. Originality/value - This study revealed variations in many aspects of PN practices among the hospitals in Kuwait and provided recommendations to improve this service. Standardization of PN practices would enhance the quality of care provided to patients receiving PN and facilitate national monitoring. This can be accomplished through the involvement of healthcare professionals with expertise in nutrition support working within proactive NSTs.
目的——本文旨在探讨科威特医院药房的肠外营养（PN）实践，并确定该服务质量改进的潜在途径。设计/方法/途径——2012年6月至2013年2月在科威特开展了一项关于PN实践的描述性定性研究。通过使用一份编制好的问卷，对七家医院的全胃肠外营养（TPN）主管药师进行深入的半结构化访谈来收集数据。该问卷获取了每家医院PN服务的相关信息，包括营养支持团队（NSTs）的存在情况、PN配制实践、质量控制以及指南/协议。访谈进行了录音，逐字转录并进行内容分析。研究结果——科威特的七家医院通过医院药房内的TPN单元提供PN配制服务。这些医院中均不存在有效的NSTs。所有TPN单元都使用纸质标准PN医嘱单来申请PN。各医院之间PN医嘱单的内容以及PN配方标签信息不一致。大多数配制的PN配方都是定制的，且装在单腔袋中。所采用的质量控制包括对PN制剂的重量分析和目视检查，且较少一致报告对无菌技术的定期评估。六个TPN单元独立制定了PN指南/协议。原创性/价值——本研究揭示了科威特各医院在PN实践的许多方面存在差异，并提出了改进该服务的建议。PN实践的标准化将提高为接受PN治疗的患者提供的护理质量，并便于国家监测。这可以通过营养支持领域专业的医疗保健专业人员在积极主动的NSTs中开展工作来实现。
