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Christine C.

Clinical Pharmacy

Module 2
1. What are the advantages of home enteral and parenteral nutrition programs
over hospital-administered programs?
Home enteral nutrition is a treatment carried out frequently due to advantages for
patients and caregivers not only for the lower risk of nosocomial infections and
better integration in socio-familiar media but also for the health administration
because of the lower economic cost and the release of hospital beds. The
advantages of this program is to decrease the health costs related to lengthy
hospital stays, and reduce the need for outpatient and emergency department
visits for parenteral drug administration.

2. Discuss how a home enteral nutrition program works.

Enteral nutrition is the preferred way of feeding patients who cannot maintain
sufficient oral intake but have a functioning gastrointestinal tract. Enteral feeding
has been used for several decades for hospitalized patients, but for the last 20
years home enteral nutrition (HEN) has been expanding in home care in many
industrialized countries throughout the world.

Patients who are suitable candidates for HPN will be provided initially with TPN
bags in the hospital. Therapy will continue until their medical condition is
stabilized. They can then undergo appropriate training to enable them to
administer their TPN bags at home. However, HPN patients may still require to
return to the hospital for regular check-ups. This means that pharmacists
involved in the care of HPN will require working knowledge of the procedures
adopted to provide care for patients in the hospital and at home.

3. Describe some features of TPN that are unique to home programs.

Home total parenteral nutrition (TPN) presents many challenges to the home
health care team, with the increase in patient acuity, advance in technologies,
and increase in stringent guide lines set by insurance companies. A well-
managed home TPN program can provide benefits through decreased health
care cost to society and increased quality of life for the patient.
Comprehensive fluid management

• Includes TPN as well as Enteral feeds & Non-TPN IV infusions (such as arterial
line, dopamine infusion etc) to provide complete & precise fluid management.

Very friendly, easy to learn, used

• Very easy to learn. Requires less than 30 minutes of initial orientation to be able
to use the program proficiently. Extensive on line help makes data entry intuitive.

Highly customizable

• Maximum and minimum values for TPN additives & concentrations of solutions
used for TPN can be customized according to institutional policies
• e.g. Maximum dextrose concentration in peripheral lines, maximum osmolality in
peripheral lines, limits for proteins, lipids and other additives are all customizable

4. Will nutrition team in hospitals in the Philippines is highly recommended?

Support your answer.
Yes, incorporating nutrition team in various hospitals in the Philippines is highly
recommended. One of the principal aims of nutrition education is to provide
people with adequate information, skills and motivation to procure and to
consume appropriate foods. Education programmes can focus on strategies to
improve family food supplies and efficient utilization of available food and
economic resources to provide well balanced diets and better care for vulnerable

Nutrition plays a critical role in human resource development since deficiencies in

essential nutrients lead to malnutrition, which affects an individual's mental and
physical state, resulting in poor health and poor work performance. In addition, a
hungry, malnourished child may have mild to serious learning disabilities,
resulting in poor school performance; a sick, poorly nourished individual will not
respond well to treatment, could lose many working hours and may continue to
drain family and national resources. Thus, malnutrition may undermine
investments in education, health and other development sectors.
When human potential and resources are trapped in the vicious cycle of
malnutrition, development goals and improved standards of living will not be
realized. Hence, nutrition should be at the centre of socio-economic development
plans and strategies in the Philippines.