Multidisciplinary Workgroup for the Improvement of preparation practices for parenteral nutrition

9 October 2015

D. Betton1, M. Leduc1, M.E. Moulies2, Y. Gauquelin1, C. Fijalkowski1, V. Guillemin1 1 Pharmacie
2 Néonatalogie
Centre Hospitalier Territorial de Nouméa
BP J5 98849 Nouméa cedex, Nouvelle-Calédonie

Parenteral nutrition injections (NP) are prepared by nurses in neonatalogy’s department. The geographic isolation of our hospital doesn’t allow us to outsource this activity. The hospital pharmacy will only be equipped for such preparation in 2016 (new hospital). Following Chambery’s incidents, a multidisciplinary workgroup led by the pharmacy department has been formed to improve practices.


The workgroup is composed by the management team, the Pharmacy, Neonatology, Hygiene, Biochemistry and Biomedical departments. The Evaluation of the circuit and the aseptic preparation of NP was performed: sterility test, Media Fill test, determination of endotoxins and surface sampling.


The circuit is not secure: computerized prescription on Excel, no pharmaceutical validation, no specific procedure nor quality assurance documentation. Over three days, 33 solutions and 12 lipid syringes were manufactured. The microbiological results show that 50% of solutions (S), 33% of syringes lipid tests (L), 7% of Media Fill’s solution are contaminated. Identified germs are: Kocuria spp (S), mold (S), Micrococcus luteus (B, L), Bacillus cereus (S, L), Microbacterium spp (L), Staphylococcus spp (S, L). The endotoxin doses are compliant. 25% of gelose-agar are contaminated.


A prescription software will be deployed and an isolator installed near the neonatology department. The pharmacy department will be in charge of the outsourced activity: NP pharmaceutical analysis, preparation, validation. The physicochemical and microbiological controls will be systemized. Intermediate measures have been taken until the isolator can be used: Re-evaluate the possibility to prescribe commercialized standard solution on a daily basis, audit preparation-administration practices and document specific procedures for the preparation of NP infusion filters referencing 0.22 and 1.2 microns.

Discussion forum

GERPAC provides for its members a discussion forum specifically devoted to technology in hospital pharmacy

Access forum

Association Loi 1901
Siège social : Chez Jean-Yves Jomier / 8ter rue Léon Bussat, 64000 PAU
Immatriculation formation N° 72 64 035 30 64
Contact us Legal notes - Management of personal data
Réalisation : Développeur web WordPress & SPIP freelance