The patient became independent, confident in his abilities and successfully administered all prescribed therapies at home without further readmissions to the hospital.Ĭonclusion: HPN is a complex therapy requiring significant patient education, reinforcement and support for success.
The dietitian reinforced education, reviewed HPN administration and hydration infusion during weekly calls.
The nursing agency provided additional hands-on patient education and daily visits to ensure the patient was infusing as prescribed. The dietitian informed the nutrition support team and nursing of the patient's literacy challenges. He explained how he accidentally infused multiple doses of hydration, missed the antibiotics and had difficulty hooking up the PN (Image 1). During the nutrition assessment call, the patient revealed to the dietitian that he could barely read. Within 3 days, the nursing agency reported the patient had 5 doses of IV antibiotics, 0 doses of IV hydration and was not sure if he was administering HPN correctly. The infusion nurse provided education regarding administration of all therapies. He was then set up with a new agency and sent home with HPN, intravenous (IV) antibiotics, and IV hydration. After 7 days, he was readmitted because the nursing agency was unable to provide adequate supplies for the ECF. He verbalized understanding, performed return demonstration, and discharged home. The infusion nurse met with the patient in the hospital to complete a nursing assessment, review expectations for home infusion and provide basic education regarding administration of HPN. The new HPN team reviewed the case, accepted the patient on service and set up new nursing. The patient had been with another infusion provider and nursing agency, neither wanted to resume care due to reported non-compliance. Patients with low literacy skills had poorer health, higher rates of hospitalization and experienced higher health care costs.Ĭase Presentation: A 62 year old male with a high output enterocutaneous fistula (ECF) was readmitted for acute kidney injury (AKI) related to dehydration, then referred to a national home infusion provider for HPN (Table 1). Studies show a correlation between low literacy and the impact on healthcare costs. Home parenteral nutrition (HPN) patients with low literacy skills may be labeled as non-compliant if they are unable to follow their prescription, have negative outcomes, or are readmitted back to the hospital. Literacy is defined as the ability to understand, evaluate, use and engage with written texts to participate in society, to achieve one's goals, and to develop one's knowledge and potential. P1 - Is My Patient Non-Compliant or Do They Have Low Literacy Skills? A Case ReportġOptum Infusion Pharmacy, San Antonio, Texas P134 – P157 Pediatric, Neonatal, Pregnancy, and Lactation Parenteral Nutrition Therapy P111 – P133 GI and Other Nutrition and Metabolic Related Concepts P86 – P110 Critical Care and Critical Health Issues P57 – P85 Malnutrition, Obesity, Nutrition Practice Concepts and Issues
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