Background To improve precision and error-free prescribing of patient specific parenteral nutrition (TPN) should be one of the main goals in neonatal intensive care.
Objective To design a PC based parenteral nutrition calculator and compare the error rate to paper-based (manual) prescribing of TPN.
Methods We designed a parenteral nutrition calculator with Borland Delphi package (Borland, U.S.A.) running on Microsoft Windows platform (Microsoft, U.S.A.). We compared manual calculations to the software calculations. Errors were divided into four categories: type I – formal errors, type II – errors with mild impact on the therapy, type III – errors with significant impact on the therapy, type IV – life threatening errors. We also measured times for one calculation.
Results Software development time was two months. The number of orders was the same in paper-based and computer-based systems (100 orders each group). There were not any calculation errors in the computer-based system. In the paper-based system we have observed 6% of type I errors, 11% of type II errors, 1% of type III errors, 0% of type IV errors. Average time to manually calculate one order of TPN was 12 minutes
Conclusion The software provides rapid and error-free definition of the parenteral nutrition, taking enteral feeding into account. Furthermore it has advantages over paper-based systems (history of every patient, features as different units, Ca/P solubility calculations, heparinization of infusion, real intake of minerals, osmolality of infusion and caloric calculations). The computer system can significantly reduce calculation errors and save time for the staff.
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