Preparing patients for home parenteral nutrition

A comprehensive, interdisciplinary program for patients requiring home parenteral nutrition (HPN) is described. This program begins with an initial patient assessment, which includes medical prerequisites and evaluation of patient motivation and learning abilities, family supports, emotional status, and individual life-styles. The teaching phase involves instructing the patient in the tasks necessary to self-administer parenteral nutrition at home. Problems that can arise are presented, and patient self-monitoring for adverse reactions and problem solving is emphasized. Outpatient follow-up is provided by the interdisciplinary Nutrition Support Service in a clinic setting. Specific components of these visits in relation to physical and emotional adjustment to HPN are discussed. The Nutrition Support Service recognizes a long-term commitment to patients receiving HPN, and members of the team are available to assist patients when problems occur.