Hello!
My organization has been developing a downtime plan for providing parenteral nutrition (TPN, PN) during an electronic health record (EHR) unplanned downtime event. Currently, PN is provided using custom internally compounded PN (using Baxter Exactamix) and using commercially available premixed solutions (e.g., Clinimix, PeriOlimel, Olimel, SmofKabiven, SmofKabiven Peripheral).
We had a close call during an unplanned ERH downtime event. A transcription error (not detected by an independent double check) occurred during manually inputting a recipe into the Exactamix. The error was caught by happenstance prior to administration. The close call prompted scrutiny of what level of PN service is safe to provide when having to deviate from normal PN workflows and the safeguards that our EHR provides. We are considering restricting PN service to only commercially available premixed solutions (with no additives) in the event of a downtime.

Does your organization restrict what types of PN can be ordered during an ERH downtime event?
What alternatives are made available?

Thanks!