For those in home care or any one who would like to offer : Do you instruct your patients to check for a blood return prior to each dose of med infused? INS standards say the nurse should check for a blood return prior to infusion of each dose does this carry over to the patient/family in home care? I have my thought os the subject but ...
Thanks Ann Marie Parry >>> "Elizabeth Harmon" <[EMAIL PROTECTED]> 4/27/2006 7:17 PM >>> Talking with our pharmacy, there is no guidelines that he has ever heard of that state you must put Vanc of any dose up to 1.5gm in 500ml to meet guidelines. Standard dosing is usually 5mg/ml because you don't always know if you patient has a peripheral line or gotten their central line yet. For home based patients they all have a central line and our pharmacy goes up to 10mg/ml based on the literature out there. For inpatient use they use the up to 1.5 gm in 250ml because with overfill and fluid of the vanc it is well over 300ml meeting the 5mg/ml guideline standard. They do this until they have confirmation the patient has a central line. They also adjust the amounts of fluid for various doses. Pharmacy also questioned that your facility may have a instituitional policy and that is why they are now insisting on this extreme amount of fluid. Check that out. My question to them is if Vanc is being ordered q 8hrs as it is sometimes that is 1500 of fluid and some of our home based patients could not tolerate that type of extra overload. I would recommend asking to see the guidelines they are going by and I will attempt to get the literature from my pharmacist to support the 10mg/ml to share with the group. Our pharmacy set up at our facility has been showcased for it's set up. We have a dedicated Home based pharmacist monday -friday. The CCU/ICU has 1 pharmacist assigned to that unit. The other acute care floors have no more than 2 floors assigned to one pharmacist. We regularly on a daily basis interact with our pharmacist and they are quite a visible force in our facility. We are very lucky. This is why I would even put this information out. They are on the cutting edge of some of our pharmacy protocols. I hope this helps. Betsy Harmon RN CRNI Vascular Access Team Critical Care Unit Alaska Native Medical Center Anchorage, Alaska [EMAIL PROTECTED] ----- Original Message ----- From: <[EMAIL PROTECTED]> To: "Riley, Deb" <[EMAIL PROTECTED]> Cc: <[EMAIL PROTECTED]> Sent: Wednesday, April 26, 2006 2:49 PM Subject: Re: vanc infusion volumes > We put all Vanco doses in 250ml and haven't had any problems. We always > use a central line and usual > infusion time is 60 minutes unless the patient has rate-related reaction. > Do you know to which guidelines > the pharmacist is referring? > > ----- Original Message ----- > From: "Riley, Deb" <[EMAIL PROTECTED]> > Date: Wednesday, April 26, 2006 2:18 pm > Subject: vanc infusion volumes > >> Can homecare members give me some feedback on how your vanc is >> suppliedfor home infusion. We used to have any vanc doses up to >> 1.5gm put in >> 250ml diluent to infuse over 60-90 minutes. Anything over 1.5gm >> went in >> 500ml of diluent to infuse over 2-2 1/2hr. The pharmacist is now >> telling us they have to put 1.5gm in 500ml in order to meet >> guidelines.Is everyone else doing the same? >> >> >> >> Deb Riley RN CRNI >> Infusion Supervisor >> Summa's Homecare >> Akron, Ohio >> >> >> >> > IMPORTANT WARNING: The information in this message (and the documents attached to it, if any) is confidential and may be legally privileged. It is intended solely for the addressee. Access to this message by anyone else is unauthorized. If you are not the intended recipient, any disclosure, copying, distribution or any action taken, or omitted to be taken, in reliance on it is prohibited and may be unlawful. If you have received this message in error, please delete all electronic copies of this message (and the documents attached to it, if any), destroy any hard copies you may have created and notify me immediately by replying to this email. Thank you.
