Support of home parenteral nutrition by hospital home care services' center in Rhone-Alpes region

Hospital home care services are developed throughout the entire country. Despite minor variations in accesses and runnings, it shares the properties and duties of a classical structure of hospitalization. It has to be certified by the French Health Authority ( Haute Autorite de sante), and has to organize the training of the stakeholders as well as the coordination of the activities shared with hospital departments. Due to the complexity of treatment programs and the high risk of specific adverse events, hospital home care services are required for the follow-up of patients receiving parenteral nutrition. Such a multidisciplinary approach (including the guaranty of 24 hours a day availability, the coordination of the stakeholders from both outside and inside the hospital, as well as the continuity of the caring process) is a useful alternative towards hospital admission. Medical treatments are delivered according to the good clinical practice rules. Medical practices are optimized thanks to the use of recommendations and standardized protocols shared by all the health professionals involved. The risk/benefit ratio of parenteral nutrition should be regularly discussed, recorded and evaluated. (C) 2013 Elsevier Masson SAS. All rights reserved.