Radical change or business as usual?
Are ASPEN's recommendations tough to follow?
While the thought of more guidelines and recommendations to follow may leave your pharmacist wondering where it all ends, the fact of the matter is that for home infusion pharmacies, the changes could be minimal.
"Home infusion pharmacies are already close to the safe practice guidelines, except for the label," says Jay Mirtallo, MS, RPh, FAHSP, BCNSP, a specialty practice pharmacist in surgery/nutrition at The Ohio State University Medical Center in Columbus, OH, and a member of the American Society of Parenteral and Enteral Nutrition's (ASPEN) National Advisory Group (NAG) that developed the recently released total parenteral nutrition (TPN) pharmacy guidelines.
Mirtallo points out that any home infusion provider that is accredited by the Joint Commission on the Accreditation of Health Care Organizations is likely already doing most of what ASPEN now recommends.
"The Joint Commission has been accrediting providers where pharmacists go in and evaluate their processes and procedures, and in almost every other area of pharmacy it's not pharmacists who are doing the evaluations," says Mirtallo.
NAG home care representative Barbara McKinnon, PharmD, BCNSP, director of business development for Nova Factor, a biotech company in Memphis, TN, says that for accredited providers, only one area will likely require change. "For those of us who practice in home care, the importance of these guidelines is they are going to provide us with standard language where we communicate label information among different treatment settings," she says. "More and more people have moved to outpatient care such as the home or outpatient infusion settings, and the problem in the past has been that everyone has prescribed and labeled TPN differently, and patient harm has occurred because of the differences in labeling and compounding practices among these sites of care."
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