PP162 - DIETITIAN-LED PARENTERAL NUTRITION ORDER ENTRY VS. PHYSICIAN PRESCRIBING IN SURGICAL PATIENTS: A RETROSPECTIVE BEFORE–AFTER STUDY OF ERROR RATES

PP162

DIETITIAN-LED PARENTERAL NUTRITION ORDER ENTRY VS. PHYSICIAN PRESCRIBING IN SURGICAL PATIENTS: A RETROSPECTIVE BEFORE–AFTER STUDY OF ERROR RATES

A. Partoush Abbou^1,*, D. London Barzilai¹, B. Sandler¹, M. Ben Meleh¹, G. Sroka²

¹Nutrition, ²Surgery, Bnai Zion Medical center, Haifa, Israel

Rationale: Parenteral nutrition (PN) prescribing is complex and error-prone, with implications for patient safety. We evaluated whether dietitian-led PN order entry, with physician co-signature, improves prescribing accuracy compared to physician-entered orders.

Methods: This retrospective, single-center, before-and-after study was conducted in a surgical ward. The unit of analysis was the individual PN prescription. All prescriptions over two periods (September 2024–February 2025 [pre-intervention] and March–May 2025 [post-intervention]) were reviewed. During the intervention, PN orders were entered by a ward dietitian with physician co-signature. Prescribing errors were defined as any deviation from the dietitian recommendation and categorized as discrepancies in infusion rate, duration, solution type, or prescriptions issued without a dietitian recommendation. The primary outcome was the proportion of prescriptions with ≥1 error.

Results: A total of 229 PN prescriptions were analyzed (157 pre-intervention, 72 post-intervention). In the pre-intervention period, 23/157 prescriptions (14.6%) contained ≥1 error, with 37 total errors. In the post-intervention period, 3/72 prescriptions (4.2%) contained ≥1 error, with 5 total errors. This corresponds to an absolute reduction of 10.4% (95% CI 1.2–17.4; p=0.038), representing a relative reduction of ~71% in prescribing errors.

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Conclusion: Dietitian-led PN order entry with physician co-signature was associated with a significant and clinically meaningful reduction in prescribing errors. This workflow may enhance PN safety through improved alignment with nutritional recommendations. Further evaluation in larger and longer-term studies is warranted.

Disclosure of Interest: None declared