As the Senior Director for Clinical Practice, Quality, and Advocacy at the American Society for Parenteral and Enteral Nutrition, Peggi Guenter’s career has run the gamut, from clinical work to research to editorial and beyond—but her career started a lot earlier than most. “At the age of four,” Peggi says, “I gave my brother an extra dose of oral vitamins. That, I believe, was the start of my nutrition support nursing career!”

However, it wasn’t until after she graduated with a BSN from the Medical College of Virginia that she concentrated on patient nutrition. Following her graduation she worked as a Surgical and Trauma ICU nurse and recalls patients whose nutritional needs dropped to the bottom of the priority list during their treatment:

“Many lost weight, did not heal wounds, and stayed in the ICU for long periods of time. I sought out the Nutrition Support Team at the Hospital of the University of Pennsylvania (HUP) to find out more about IV nutrition and joined their team in 1981.”

That experience helped her develop a passion for parenteral (IV) and enteral nutrition (tube feeding) as  therapies for all ages and patients in all healthcare settings, from the ICU to home. “It is critical that nutrition support be given,” she says, “and given appropriately, safely, that the quality of care be measured and improved—in order to deliver the best outcomes for the patient.”

As Peggi’s career at HUP as a nutrition support nurse progressed, she chose Penn Nursing for her MSN degree. She began writing a number of papers for journals and books. “I really enjoyed translating science into practice for nurses and others in the nutrition support field,” she says. She went on to complete her PhD at Penn Nursing and completed a term as associate editor for a clinical journal.

“The transition to editor-in-chief of the Nutrition in Clinical Practice journal was a natural step in my career growth,” she says, “and very enjoyable to learn a lot about the world of publication.” While serving as editor-in-chief, Peggi was also the Clinical Director, Nutrition Support Service, Department of Surgery at The Graduate Hospital in Philadelphia. “Following my clinical career I began consulting, writing a book, and the American Society for Parenteral and Enteral Nutrition (ASPEN) asked me to join their staff doing special projects. Over the years my position has evolved into a senior leadership position, working with nutrition support healthcare professionals from all over the country.”

A pivotal moment in Peggi’s career came around the time she learned about enteral misconnections and wrote a paper on the topic for the Joint Commission of Journal of Quality and Patient Safety. “I received a call from a mother who had just lost her pregnant daughter and future grandchild because a nurse had connected tube feeding to an IV line,” Peggi says. “This medical error cemented in my mind that something needed to be done to change these connectors to prevent any patient and/or nurse from having this devastating event happen to them. It pushed me to do work on an ISO task force to create new safety standards for enteral nutrition connectors. Even today, I staff many safety and quality guidelines and recommendations workgroups for our area of practice at ASPEN.”

“My Penn Nursing degrees have been critical in my career,” Peggy says. “My PhD education, in particular, taught me not just how to question the status quo, but how to conduct clinical research in the field of nutrition that could be applied to patients at the bedside. That knowledge has led to many research and publications over my career—and pushed me to be an innovator in quality and safety for nutrition support therapy.”

As a result of Peggi’s tireless work in this area, she received the Institute of Safe Medication Practices Cheers Award in 2012—an award that recognizes actions that have set a standard of excellence in prevention of medication errors. She says, “This award and recognition from the healthcare safety community made me particularly proud of my work on enteral and parenteral nutrition safety and quality.”

Random fact about Peggi: She met her husband in Penn Nursing’s PhD program. When they were married in 1990, they were honored to have former Penn Nursing Dean Claire Fagin, Florence Downs, and many other esteemed Penn Nursing faculty attend their wedding.