Can pharmacists and dietitians safely prescribe and administer parenteral nutrition?

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The Pharmaceutical Journal
Vol 280 No 7503 p626-630
24 May 2008

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Original papers

Can pharmacists and dietitians safely prescribe and administer parenteral nutrition?

By Kirstine Farrer, Lindsay Harper, Jon Shaffer, Nigel Scott, Iain Anderson and Gordon Carlson

Kirstine Farrer, MPhil, RD, is consultant dietitian

Lindsay Harper, BSc, MRPharmS is principal clinical pharmacist

Jon Shaffer, FRCP, is consultant gastroenterologist

Nigel Scott, FRCS, is consultant surgeon

Iain Anderson, MD, FRCS, is consultant surgeon

Gordon Carlson, MD, FRCS, is consultant surgeon

all at Salford Royal NHS Foundation Trust and Salford Primary Care Trust.

Correspondence to:
G. L. Carlson
Department of Surgery, Clinical Sciences Building, Hope Hospital, Salford M6 8HD

e-mail gordon.carlson@manchester.ac.uk

Abstract

Aim
To determine if suitably trained pharmacists and dietitians can safely and effectively prescribe peri-operative parenteral nutrition.

Design
Assessment by two blinded independent observers.

Subjects and setting
A pharmacist and a dietitian at Hope Hospital, Salford.

Results
370 separate decisions were made. Decisions wereof major clinical benefit in 2–8% of cases, and of at least positive value in 46–63% of cases. No decisions were considered harmful or to have exposed patients to risk.

Conclusions
Pharmacists and dietitians given suitable training can safely prescribe parenteral nutrition, and may be as, if not more, capable of prescribing than junior medical staff. Consideration should be given to developing extended clinical roles for these health professionals.