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Connecting Home Parenteral Nutrition HPN Infusion for a Multi-Chamber Bag Procedure

Aim

Cavendish Homecare Professionals’ aim is to ensure that where a client requires an HPN infusion as part of their care and treatment, suitably trained care staff will be deployed to support them as required and provide high quality care that conforms to best practice.

The administration of HPN

Equipment required:

  • Bag of parenteral nutrition
  • Sanicloth Alcoholic 2% Chlorhexidine disinfection wipes x 3
  • Sterile dressing towels x 2
  • Sterile gloves
  • Sterile IV giving set

Procedure

  1. Wash hands with liquid soap provided and ensure to dry hands thoroughly
  2. Collect the equipment needed.
  3. Check the contents of the bag against the prescription and hang the parenteral nutrition on the drip stand. Open the protective outer bag and check the expiry date and integrity of the solution.
  4. Open the Sanicloth disinfection wipe and snap the protective cover off the administration port and disinfect the port
  5. Clean the working surface area with a Sanicloth and dry with a paper towel. Wipe surface again with a Sanicloth wipe and allow to dry.
  6. Wash hands again
  7. Open sterile towel – unfold touching the corners and edges only, and place on the surface being used to create a sterile field
  8. Open the IV giving set onto the centre of the sterile field
  9. Open sterile gloves and place away from the giving set.
  10. Open the second sterile dressing towel and place under the client’s line
  11. Open a Sanicloth wipe and disinfect the catheter hub and membrane of the needleless connector and allow to dry
  12. Apply alcohol gel to hands and allow to dry
  13. Put on sterile gloves
  14. Close the flow control on the giving set and grasp the administration port of the bag. Remove the protective cover of the giving set spike and insert into the administration port bein careful that the end of the giving set remains on the sterile field.
  15. Prime the giving set.
  16. Take the end off the giving set and connect to the client via the needle free connector.
  17. Remove gloves and place the giving set in the pump and programme. Unclamp the line and giving set and commence the infusion at the rate prescribed.
  18. Remove gloves, clear away rubbish and wash hands

Image of Multi-chamber parenteral nutrition and how to break the seals

 

Instructions

  1. Remove the protective over pouch and discard the oxygen absorber sachet.
  2. Confirm the integrity of the bag and seals. Use only if the bag is not damaged, if the non-permanent seals are intact (no mixture of the contents of the 3 compartments) if the amino acid solution and the glucose solution are clear or slightly yellow and there are no visible particles. The lipid compartment will be milky in appearance.
  3. Ensure that the product is at room temperature when breaking the seals.
  4. Manually roll the bag onto itself starting at the top of the bag (hanger end). Continue to roll the bag until the seals are broken and mix by inverting the bag at least 3 times.
  5. After the seals have been broken and mixed it will have a milky like appearance.

 

 

Date: January 2024

Version: 5 (Review)

Source:  ECM