Twenty thousand people are hospitalized and suffer from malnutrition. Oncological, neurological, kidney, intestinal, liver disease, or accident victims who must use artificial nutrition to meet their nutritional needs.
The technique can be done through probes (enteral nutrition) with oral, nasogastric support, or directly into the blood (parenteral nutrition) with a peripheral or central venous catheter, essential in more complex cases, especially in children.
The kit at home
Today in our country there are about 3 million parental nutrition treatments administered and, thanks to a unique service in Italy that goes from the composition of nutritional bags tailored to the patient, made according to a doctor’s prescription, up to the home delivery of all the materials that are used to perform the therapy, these people can lead an almost normal life, even abroad. Home care can be just as safe and effective as hospital care if managed correctly, even with nursing care.
Paolo Gandullia, Director of the UOC of Gastroenterology and Digestive Endoscopy of the Department of General and Specialized Pediatric Sciences at the IRCCS Giannina Gaslini in Genoa, explains how much parental nutrition is a life-saving therapy and to do it at home it is essential to train the patient and the caregiver with the help of specialized nurses.
It goes without saying that the supply and assistance service of nutritional bags and related tool kits must guarantee very high safety, with the use of specific and monitoring protocols capable of ensuring a significant reduction of the infectious risk and / or other risks of the procedure. The nutrients (magisterial galenic preparations made to measure) or medicinal specialties, are contained in small bags produced under very strict control.
All steps of the production process are monitored and tested on the finished product to guarantee sterility. Another important element for the safety of the therapy is the transport of medicinal specialties which must be carried out according to the current regulations in force on the subject with controlled temperature means as well as the home storage of galenic bags with a dedicated refrigerator.
The care model must then be customized on the individual patient, given the difference in age, type and severity of the pathology, lifestyles. Also in this case, the prospect of partnership with an external experienced provider that can guarantee the quality and safety of the materials used but also training and counseling for patients and caregivers and support from specialized and dedicated home nursing staff comes to the rescue.
The eight rules for home parenteral nutrition
1. Knowledge of nutritional culture as a basic tool
2. Availability of a Nutrition Team with dedicated staff (doctor, pharmacist, dietician, nurse)
3. Experience of “aseptic” maneuvers (infection prevention with sterilized instruments and materials)
4. Availability of central venous access via temporary or indwelling catheter
5. Wide availability of specific products and nutritional solutions, dedicated dressing materials
6. Shared and written operational protocols
7. Knowledge of complications and their warning signs
8. Availability of a dedicated facility that takes care of the patient