Filtering Out the Facts: Recommendations to Optimize Performance of In-Line Filters for Parenteral Nutrition and Injectable Lipid Emulsion Infusions.
Marianne Gill, Adina Hirsch, Nicole Wilson
Journal: Journal of infusion nursing : the official publication of the Infusion Nurses Society
2022;45(3):137-141
PMID: 35537001
Abstract
The use of an in-line, 1.2-μm filter is recommended for the intravenous (IV) infusion of parenteral nutrition (PN), also known as 3-in-1, total nutrient admixture (TNA), or all-in-one, and injectable lipid emulsions (ILEs) infused alone through a separate IV line. While filtration of TNA was mandated in 1994 to improve patient safety, the recommendation for filtering lipid emulsions alone is relatively new and has not been adopted by all clinicians. In addition, literature references and postmarket surveillance data cite the occurrence of infusion pump occlusion alarms, which may be indicative of a clogged filter. The following review article provides an overview of filter recommendations for PN and ILE, describes the challenges of filtration with PN and ILE, and includes recommendations to minimize pump occlusion alarms that may occur from a clogged filter.
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Becton, Dickinson, and Company, San Diego, California (Ms Gill and Ms Wilson); Fresenius Kabi, Lake Zurich, Illinois (Dr Hirsch).; Marianne Gill, MS, RN, is the vice president of medical affairs for Infusion Solutions at Becton, Dickinson, and Company (BD). Ms Gill received her master of science degree in management and health administration from New England College and her bachelor of science in nursing at Rutgers University. She has acute care experience in the cardiac care unit and in home infusion therapy. Ms Gill's current role with BD Medical Affairs-Infusion Solutions includes identification of opportunities to optimize safe, high-quality, outcome-driven clinical practices and products for the patients and clinical end users. She is also a certified facilitator in Crucial Conversations and Corporate Culture.; Adina Hirsch, PharmD, BCNSP, is a senior medical science liaison for parenteral nutrition with Fresenius Kabi. She received her doctor of pharmacy degree from the College of Pharmacy and Health Sciences at Mercer University and completed an American Society of Health-System Pharmacists accredited PGY-1 residency program with a focus on nutrition support at Atlanta Medical Center in Atlanta, Georgia. Dr Hirsch worked as a nutrition support and critical care pharmacist for more than 5 years and served as an assistant professor of pharmacy practice at Philadelphia College of Osteopathic Medicine School of Pharmacy for 3 years. She has been board certified as a nutrition support pharmacist since 2013. Dr Hirsch has published articles and book chapters related to nutrition support, including the nutrition support chapter of the Manual of Critical Care Nursing.; Nicole Wilson, MSN, RN, CPHIMS, is a senior manager of medical affairs for Infusion Solutions at BD. She has more than 16 years of nursing experience, including acute care experience in orthopedics, neurology, and cardiac critical care. Ms Wilson received her master of science in nursing informatics at the University of San Diego, and her bachelor of science in nursing at California State University Dominguez Hills. She has contributed to industry journals and the 2021 revision of the American Nurses Association Nursing: Scope and Standards of Practice. Ms Wilson volunteers her time guest lecturing and sitting on the curriculum advisory board at the University of San Diego; she is also an active member of various industry organizations, such as the American Nurses Association and American Nursing Informatics Association.
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