Published online February 1, 2006
PEDIATRICS Vol. 117 No. 2 February 2006, pp. e328-e332 (doi:10.1542/peds.2005-1350)
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Of Lobsters, Electronic Medical Records, and Neonatal Total Parenteral Nutrition

Dennis T. Costakos, MD, FAAP

Department of Neonatology, Franciscan Skemp-Mayo Health System, LaCrosse, Wisconsin; Department of Pediatrics, Mayo Clinic College of Medicine, Rochester, Minnesota

At the Mayo Health System in LaCrosse, Wisconsin, there are >1000 infant total parenteral nutrition (TPN) orders placed per year. It is the most complicated order that the pharmacy fills, so a recent peer-review article in Pediatrics moved a group of us to action at our center to buy or develop a TPN calculator. We did this because no stand-alone commercial calculators were available to us, and expensive electronic medical records typically do not include TPN calculators for neonatal patients. The new software includes decision support, and the orders are consistently legible. The physician performs fewer calculations, and there are no mathematical errors. This article examines the broader significance of providers having to write their own TPN software.

Key Words: electronic records • medication errors • parenteral nutrition

Abbreviations: TPN, total parenteral nutrition • EMR, electronic medical record • ADE, adverse drug event • AAP, American Academy of Pediatrics • CPOE, computerized provider order entry

Accepted Jul 29, 2005.


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