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At a specialist paediatric centre, with 378 beds and a 31-bed paediatric intensive care unit, an expert Nutrition Support and Intestinal Failure Team (NSIFT) oversees parenteral nutrition (PN) provision, reviewing approximately 450 patients/year. NSIFT supports parent medical and surgical teams to prescribe PN for their patients as a consultative service. The hospital does not have an aseptic manufacturing unit, therefore all PN (bespoke and standard) is procured from external suppliers.In May 2025, the Trust implemented Epic electronic patient records (EPR), with the system going live on all sites/systems at once after an 18-month roadmap. The intention was to fully embed all PN workflows and processes into Epic, which had not been done in the UK.The PN module was developed and custom built by the Epic team in January 2025. Image 1 outlines the actions in the approach to go-live.Following go-live on 15/5/25, NSIFT absorbed PN prescribing activity for all patients, except intensive care (prescribed by independent pharmacist prescribers) and gastroenterology. Specific PN training was unable to be provided to staff as PN processes were finalised after Trust training was completed. Due to the complexity of Epic PN prescribing compared to paper prescriptions, and given the strict external manufacturing deadlines, it was necessary for NSIFT to manage this.There were 102 tickets submitted for incidents in Epic that had ‘PN’ specifically referred to over a 29-week period from 16/5/25 to 3/12/25. NSIFT liaised with Epic analysts daily for the first four weeks to troubleshoot and add fixes where needed, then ad hoc thereafter.In October 2025 two rapid risk assessments were conducted. The first was a patient safety risk assessment to review the patient safety incidents, review PN workflows in Epic and identify changes required to mitigate risks. The second risk assessment was to appraise if NSIFT were to continue prescribing PN, and assess the resource requirements for this. After fixes and updates were implemented in November 2025, PN was removed from the patient safety log managed by the Trust’s EPR council. NSIFT continue to prescribe PN, with the intention to review the business case for the team and optimise resources to support ongoing prescribing activity.Overall, a custom built PN module was successfully implemented into a complex EPR system. Patient safety concerns were addressed and updates made appropriately. PN in Epic has moved into a stabilisation phase and will gradually move towards optimisation for long term development.References N/AAbstract LBA9 Figure 1Roadmap for PN go-live in epic