What procedure is essential prior to discharging a patient on home parenteral nutrition (HPN)?

• A. Placement of a permanent vascular access device
• B. Training on self-care
• C. Discontinuation of all IV fluids
• D. No special procedure is required

Answer: (A)

Securing durable venous access is essential before discharging a patient on home parenteral nutrition. A permanent central venous access device (such as a tunneled catheter or implanted port) provides reliable, long-term access to deliver PN outside the hospital, enabling safe administration, proper pump use, and ongoing line care. Without stable access, there's a high risk of catheter-related complications and interruptions in nutrition. Training on self-care is important for safe home PN, but the foundational prerequisite is having the durable access in place. Discontinuing IV fluids is inappropriate because PN is the IV nutrition the patient requires, and saying no special procedure is required is incorrect since establishing reliable vascular access is a critical step.