The Scope of Infusion in Homecare
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PHS was invited to present at the local APHON (Association of Pediatric Hematology/Oncology Nurses) meeting in September. PHS IV nurse Jill Wall, RN, BSN, CRNI, presented on the scope of home infusion and all that PHS does to ensure our patients thrive at home.
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The Scope of Infusion in Homecare
- 1. The Scope of Infusion Home Care
- 2. Pediatric Home Service • PHS provides compassionate, specialized, high-tech care in the home environment, where children enjoy a better quality of life. • We understand the special and ever- changing needs of infants, children, and adolescents. • Our multidisciplinary team provides each child with a customized, comprehensive, and integrated plan of care
- 3. Multidisciplinary Team • Dr. Roy Maynard- Medical Director – neonatologist and pediatric pulmonologist, works with our care teams and your care team to ensure continuity of care and the implementation of the latest clinic policies, procedures and programs
- 4. Multidisciplinary Team • Pharmacy Staff • Infusion Nurses • Wound/Ostomy Nurse • Specialized Nutrition Services • Nutrition Support Team • Respiratory Therapists • Private Duty Nursing Services • Medical Social Worker • DME/Customer service • Biomedical Support Services
- 5. Plan of Care • Each plan of care is created to meet the individual needs of the child. We oversee the child's medication regime to keep him or her safe at home. • We teach families all steps necessary to provide therapy. • We provide patient assessment, central line management, infusion administration, education, and lab monitoring. • We offer skilled nurse visits and partner with other regional nursing agencies to deliver care outside the 11 country metro area.
- 6. Referral Process • IV coordinator receives initial phone call from referral source. • Information is sent to Pharmacy, Admissions/Billing, and PDNS (if involved with patient). • Insurance/benefits approved or denied. • Referral source notified. • Appointment scheduled at hospital or home for setup/teach upon approval.
- 7. Referral Process • Infusion case manager assigned and notified of scheduled appointment. • Regional patient: regional agency contacted and confirmed for services. Orders faxed, education materials and/or teaching provided prior to discharge. PHS regional case manager to follow. • Interpreter services arranged if needed.
- 8. Case Manager • Initial teach at hospital or home. • Follow up visits scheduled during first visit: vary depending on therapy. • 24 hour follow up phone call to assess home therapy needs. • Physician’s Plan of Treatment completed. • Care Plan Completed • Communication follow up with professional team ongoing throughout therapy.
- 17. IV Therapy • Anti-Infectives (antibiotics, antivirals, antifungals) • Blood Products- Albumin • Biologic Therapies, (Immune mediated inflammatory disorders)-Remicade • Catheter Care • Chemotherapy and symptom management • Enzyme Replacement Therapy (Glycogen Storage Disorders)
- 18. IV Therapy •Hydration •IVIG •Inotropic Therapy (Heart Failure) Milrinone •Pain/Palliative-PCA •Post Transplant Monitoring/Medications •TPN/Lipids •Other specialty therapies-Pamidronate Adverse drug reaction protocol/emergency meds
- 19. Non IV Therapy • SQIG • Peripheral/Capillary lab draws • Lovenox/Insuflons • Enteral/Food pumps • Non IV skilled nursing assessments • Wound/Ostomy care
- 20. Adverse Drug Reaction Education • Training family/caregivers signs and Symptoms of ADR (hives to anaphylaxis) • PHS RNs administering infusions carry ADR kits • Certain therapies or patient history of ADR require kits to be left in the home (Epi- pen/Benedryl) • First dosing completed in hospital or short stay unit.
- 21. PHS Infusion Education • Ensures quality care at home • Develops a safe plan of care that is grounded in clinical education and technical support at a 5th-grade reading level. • Classroom instruction –internal/external • Customized patient education materials. • One on one mentoring • Follow current standards for infusion therapy -INS Standards
- 22. Nursing Education Classes • Pediatric Assessment • IV Basics/ CVC • Caring for an Implanted Port • TPN/Lipids and Ambulatory Infusion • Starting a Peripheral IV • Drawing a Blood Specimen • Home Care Documentation and Legal Issues • Safety and Infection Prevention
- 23. PHS We specialize in helping kids be kids – at home – no matter what their medical challenges. PHS kids THRIVE!