Cost, Time, and Error Assessment During Preparation of Parenteral Nutrition: Multichamber Bags Versus Hospital-Compounded Bags

JPEN J Parenter Enteral Nutr. 2019 May;43(4):557-565. doi: 10.1002/jpen.1436. Epub 2018 Aug 29.

Abstract

Background: Parenteral nutrition (PN) is associated with material and manpower costs and requires preparation time. The aim of this study was to evaluate the cost of PN using multichamber bags (MCBs) compared with hospital-compounded bags (COBs). The secondary aim of this study was to assess and compare preparation time and errors related to the production and preparation processes of PN bags.

Materials and methods: A prospective, observational, cost-accounting study was conducted in 10 Spanish hospital pharmacy services. The cost assessments included components, raw materials, and hospital staff. Only PN bags with equivalent volume and nutrition value were included in the analyses. Assessment of errors related to PN was performed simultaneously with the cost and time comparison analyses.

Results: Among the 597 PN bags (295 MCBs, 302 COBs) evaluated, 392 PN bags (295 MCBs, 97 COBs) had an equivalent volume and nutrition value. The mean (standard deviation) total cost of the MCB was $62.11 ($12.34) per bag compared with $67.54 ($8.50) per bag for COBs, resulting in a significant cost savings of $5.71. On average, the time required to prepare an MCB was 38 minutes shorter (P < .001). Significantly fewer total number (percent) of errors was observed in the preparation of MCBs (3 [1.0%]) compared with COBs (15 [5.0%]); P < .01).

Conclusion: The use of MCBs results in significant savings in cost and preparation time, which may have a beneficial effect on the economic burden associated with PN as well as a reduction in errors related to PN preparation.

Keywords: compounding; cost analysis; hospital-compounded bag; multichamber-bag; parenteral nutrition; preparation error; safety; standardization.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Costs and Cost Analysis*
  • Hospitals
  • Humans
  • Medical Errors / statistics & numerical data
  • Parenteral Nutrition / economics*
  • Parenteral Nutrition / instrumentation*
  • Parenteral Nutrition Solutions / economics*
  • Pharmacy Service, Hospital
  • Prospective Studies
  • Time Factors

Substances

  • Parenteral Nutrition Solutions