We frequently set up home infusion pumps for continuous 5FU.  They are then 
followed by the VNA who go out once to make sure they understand how to use the 
pump and what to do in an emergency situation.  The patient can then call the 
on call VNA nurse if there is a problem.  They also have the 24hr number for 
the infusion provider.   
 
If I am setting up the pump in our outpatient infusion room because the patient 
has received other chemo prior to setting up the continuous infusion I always 
teach both the patient and a family member how to handle chemo, precautions to 
take if there is a leak, how to handle clothing and wash them if they become 
soiled with chemo.   I teach them how to use the pump and how to troubleshoot 
problems.  They are given chemo gloves, disposal bag, flushes and important 
phone numbers.   I cover all issues related to the chemo, the pump and the 
device that the medication is infusing into.  I then verify the 24hr on call 
nurses number and the infusion providers 24hr number.
 
 
Margaret M Nicastro, CRNI, OCN
Coorordinator IV Therapy/Oncology
Gettysburg Hospital
147 Gettys Street
Gettysburg, PA 17325
Phone:  717-337-4312
Fax:  717-337-4485
 

________________________________

From: [EMAIL PROTECTED] on behalf of Lynn Hadaway
Sent: Sat 2/18/2006 12:12 PM
To: Jen R; [EMAIL PROTECTED]
Subject: Re: 24 hour support for home chemo



No you are not stuck in the past. This support after hours is
necessary. I am not aware of anything pertaining to chemo infusion
but there are guidelines for Outpatient Parenteral Antimicrobial
Therapy that states this support is required for these programs.
Since antineoplastics can be more dangerous that antibiotics, I would
think the same level of support is required. ER's have many skills
but I would not include management of complex infusion therapy
problems among there best practices. Lynn

At 10:18 AM -1000 2/17/06, Jen R wrote:
>I know this has been discussed before, but I'm not having much
>success searching the list.
>
>What is currently being done for patients who have chemo, usually
>5-FU, initiated at an ambulatory infusion center. They then go home
>and return several days later to have the infusion discontinued.  Is
>there a number for the patient to call after hours if there is a
>problem with the infusion, such as the pump alarming or a
>disconnection?
>
>When I did home infusion (for an infusion company), we had nurses on
>call 24/7 to provide assistance and visits if necessary for anyone
>receiving chemo at home, as well as for all our other patients.
>Locally, some ambulatory centers are hooking up and d/c-ing home
>chemo, with the patient basically having no support for after hours
>beyond "go to the ER if you have a problem".
>
>I strongly believe that these patients deserve round-the-clock
>support, and that to institute a home chemo program without this
>support does not comply with standards of care.
>
>Am I hopelessly stuck in the past?  What are other locales doing?
>
>Jennifer Rabalais, CRNI
>Infection Control Coordinator
>North Hawaii Community Hospital
>Kamuela, HI


--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861




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