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Recently, I have looked into the utilization of premix PN (three chamber bag system). Below steps may help in assessing the utilization of premix PN

• Assess current PN utilization and patient population by performing utilization review
• Retrospective or prospective PN utilization review. (looking at the below criteria)
  • Age group (Adult, pediatric, neonates)
  • Central or peripheral PN
  • Indications, comorbidity​​
  • Short term or long-term
  • Number of PN orders per day

• You may also asses pros and cons of each customized versus premix

1- Safety: Measured by ADR (Complication)

2- Efficacy: Since there is no single indicator to assess nutritional status. Efficacy can be assessed by comprehensive evaluation of weight, electrolytes level, hydration status, prealbmuin etc.

3- Cost: Direct (Cost of the PN bag customized versus premixed) and indirect (staffing and equipment)

Usually, stable young patients with no co-morbidity will tolerate ready-made PN and it’s a cost saving to the institution. However, if the majority of patient population is pediatric and neonates then customized can’t be replaced by ready-made.

Hope this will help