Total Parenteral Nutrition Patient Instructional Video

For all of our Patients on a Home Infusion TPN therapy, this instructional video can assist you with remembering the steps for your infusion. Please refer back to this video if you have questions about your TPN infusion.

This instructional video will assist with your total parenteral nutrition, or TPN administration.

You will begin by removing the TPN (and separate lipid bag if applicable) bag from your refrigerator 2-3 hours ahead of time to allow them to warm up to room temperature. Make sure you check labels for the correct information, dosage, and expiration date. Check that there are no cracks or leaks in the bags.

Right before you administer the TPN, wash your hands with soap for 30 seconds and dry them thoroughly.

Gather your supplies and make sure you have a clean work surface. Your supplies include the TPN bag (separate lipid bag if applicable), alcohol wipes, one saline syringe, multivitamin vials and/or other additives if ordered, one empty syringe with needle and extra needles for the additional additives.

Withdraw the multivitamins into one syringe and place a needle on the additional additives.

Then you will add the multivitamin and any other additives as directed to the TPN just prior to hanging by wiping the injection port on the TPN bag with alcohol for 15 seconds and letting air dry for 15 seconds. Inject the multivitamins and the additional additives into the injection port on the TPN bag wiping with alcohol between injection. Lightly rock the bag to disperse the yellow multivitamin throughout the bag of TPN.

Replace the batteries in the pump.

Then, load TPN tubing into the pump. Follow the yellow and blue markings on the pump and on tubing to place it in correctly.

The next step is to prime the tubing. First, turn the pump on and press yes on program. Press yes on repeat rx. The pump will then scroll through the program that has been programmed in the pump by our pharmacists for your infusion. Press the prime button once and the pump will remind you to release the clamp on the tubing if it is clamped and to have the tubing disconnected from the patient. Press the prime button again and hold down until fluid is at the end and dripping out then release the prime button. Finally, you will press yes to exit, but leave the pump turned on.

The next step is to use saline to flush the catheter. Remove the orange alcohol cap from the end of your PICC line. Wipe the injection cap with alcohol for 15 seconds and then let air dry for 15 seconds. Hold the injection cap in one hand and push the syringe directly onto the cap and screw it on. Then, inject the saline using a push-pause, push-pause method. Remember, the injection cap must remain attached to your catheter, do not remove it.

Now it is time to administer the TPN. Attach the TPN tubing to the injection cap and unclamp. Then, press run/pause when prompted to run to start the infusion. A green light will start flashing when the TPN is running.

If your infusion is a 24-hour infusion, start back at step 1 to get a new bag started. If your infusion is not continuous and runs on a cyclic schedule, then follow the following steps:

First, gather the following supplies on a clean work surface- alcohol wipes, one saline syringe and one heparin syringe and an orange alcohol cap.

Second, turn the pump off. Then, you will flush your catheter with saline. Wipe the injection cap with the alcohol wipe for 15 seconds and allow to air dry for 15 seconds. Hold the injection cap in one hand and push the syringe directly on the cap and screw it on. Inject saline using the push-pause, push-pause method. Wipe again with alcohol for 15 seconds and air dry then you will flush the catheter with heparin. Close the clamp on the extension tubing after removing the syringe to reduce the chance of blood back-up and the clamp on your PICC line if one exists. Place an orange cap on the end of your PICC line.

The last step is waste disposal. Used syringes without needles or blood can be placed in household trash unless otherwise instructed by your nurse. Syringes that do have needles or are blood contaminated should be placed in the red sharps container. The sharps container can be sealed closed and put in your household trash when its three-fourths full, when you have a replacement bag.

Finally, call landmark infusion at 866.388.3883 if you have any questions or problems or if there is redness, swelling, or tenderness at your iv site. Remember, our pharmacists are here for you 24/7.