Home Infusion Therapy Flashcards
Accreditation does whatttt?
Provides patients, referral sources and payers the assurance that the pharmacy meets a basic level of quality in patient care
Accrediting bodies include:
Joint commission CHAP PCAB HQAA ACHC Medicare
Advantages of Home Infusions
Patient convenience
Decreased exposure to nosocomial pathogens
Decreased acute care costs
Improved quality of life
Disadvantages of Home Infusion
Difficult to obtain reimbursemetn for some service or pts (immune globulin, economically disadvantaged patients, uninsured pts)
Adverse effects with Home Infusion
Infections
Thrombosis
Physical limitations
CVADs is a
Catheter with tip placed in the superior vena cava
- Allows for intermittent connection to IV tubing for infusing solutions or withdrawing blood
CVADs are preferable in:
outpatient settings
- Rapid hemodilution of infusate
Less venous irritation
May be used for long periods of time without complications
Peripherally Inserted Central Catheter Placement
Inserted in a peripheral vein in the antecubital fossa
Threaded into the SVC
Peripherally Inserted Central Catheter Uses
Long-term infusion therapy
Blood collections
Patient considerations
Suitable for patients requiring daily infusions
Not recommended for those with traumatized antecubital spaces or history of failed cannulation attempts
Peripherally Inserted Central Catheter Advantages
Operating room not required for insertion/removal
Painless access
Minimal scarring
Peripherally Inserted Central Catheter Disadvantage
Weekly dressing changes
Limited upper extremity movement
Thrombosis risk
Tunneled Catheter Placement
Inserted SQ and tunneled between the vein insertion site and the skin exit site
Tip is usually advanced into the SVC
Tunneled Catheter Uses
Long-term infusion therapy
Blood collection
Hickman catheter:
Larger catheter lumen, preferred for adults
Broviac catheter:
Single-lumen, preferred for pediatric patients
Tunneled Catheters Advantages
Does not require dressings
Single or multiple lumen options
Not as restrictive as PICC lines
Tunneled Catheters Disadvantages
Surgical placement and removal
Administration sets and add-on devices
Scar tissues formation around catheter
Port Placement
Completely implanted beneath the skin
Portal body connected to think tube which is inserted into a vein
Port Use
Long-term cyclic infusions and/or blood specimens
Reservoir option: slowly releases meds into the bloodstream
Port Patient considerations
May be placed either in the chest or arm
External parts not exposed when port is not in us
Port advantages
Least physically restrictive of CVADs
Not visible externally or under the skin
Minimal site care required
Port disadvantages
Needle insertion each time port is accessed
Surgical placement and removal
Skin breakdown/scar formation
Elastomeric Infusion Device
Portable infusion ball which can be carried in patient’s pockets
“Eclipise”
- Outpt Abx Infusion Device
Vista Basic Pump and Acclaim Infusion Pump
Stationary infusion device attached to a pole for non-ambulatory pts or large volumes of administration
- Outpt Abx Infusion Device
Cadd Infusion Pump
Ambulatory lightweight pump
- Outpt Abx Infusion Device
Eclipse Advantages
Range of sizes Minimal nursing labor No programming errors Ideal for pt mobility Easy administration and disposal
Eclipse Disadvantages
Expensive
Not covered by all third party payers
Variable stability
Compounding with the Eclipse
Leur-lock, needleless system Unclamp and remove the cap from the fill port Add diluent first and drug volume second Replace cap Re-clamp and label
Patient Instructions for Eclipse
Must allow the pump to warm to room temperature
Do NOT microwave
May put in sunlight or warm water
