Maswoswe J J, Newcomer D R, Quandt C M
Am J Hosp Pharm. 1987 Jun;44(6):1376-81.
A hospital's use and pharmacy costs of parenteral nutrition (PN) therapy before and after implementation of standardized PN formulas, prescribing guidelines, and preprinted order forms were compared. The study hospital, a large teaching institution, did not have a formal PN team. Guidelines for prescribing were promulgated by the pharmacy and therapeutics committee, the quality assurance committee, and the medical staff executive committee. Records of all patients receiving PN therapy were audited for six-month periods before and after implementation of the program. Cost data associated with decreased PN and albumin wastage, reduced labor and materials costs, inventory reduction, decreased inventory holding costs, and competitive bidding were analyzed. After implementation of this program, the number of wasted PN solutions was reduced by 55.8%, and the cost of PN solutions decreased by 36.9%. Use of albumin-containing PN solutions was reduced by 85.3%. PN solution preparation times were reduced by 66.1% (a reduction of 58.7% in preparation costs), and PN acquisition costs were reduced by 54.5%. A total annual savings of $170,722 was realized, plus a one-time cost savings of $15,632 from inventory reduction. Use of standardized parenteral nutrition formulas and prescribing guidelines can substantially decrease the cost of patient care.
比较了一家医院在实施标准化肠外营养（PN）配方、处方指南和预印订单之前和之后的PN治疗使用情况和药房成本。研究医院是一家大型教学机构，没有正式的PN团队。处方指南由药学与治疗学委员会、质量保证委员会和医务人员执行委员会颁布。对该计划实施前后六个月内所有接受PN治疗的患者记录进行审核。分析了与减少PN和白蛋白浪费、降低劳动力和材料成本、减少库存、降低库存持有成本以及竞争性招标相关的成本数据。实施该计划后，浪费的PN溶液数量减少了55.8%，PN溶液成本下降了36.9%。含白蛋白的PN溶液使用量减少了85.3%。PN溶液配制时间减少了66.1%（配制成本降低了58.7%），PN采购成本降低了54.5%。每年总共节省了170,722美元，加上因减少库存一次性节省了15,632美元。使用标准化肠外营养配方和处方指南可大幅降低患者护理成本。
