Article Text

  1. J. Miletin1,2,
  2. I Berka1,
  3. J Janota3,
  4. I Burianova3,
  5. Z Stranak.1
  1. 1Neonatal Intensive Care Unit, Institute for the Care of Mother and Child, Prague, Czech Republic
  2. 2Neonatal Unit, Coombe Women and Infants University Hospital, Dublin, Ireland
  3. 3Neonatal Intensive Care Unit, Thomayerova Faculty Hospital, Prague, Czech Republic


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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