Nadine,
I am not sure it NHIA has a position on this but it is the reasonable and
prudent thing to do. Make sure the patient has the best device in place for
the therapy to be delivered in the home - where patients and families are not
as careful about protecting the their lines, there is very little "control"
over them, no one is there to assess for infiltration, etc. Early assessment in
the hospital with early PICC placement helps to alleviate the hold up on
discharge and is less stressful for the PICC team. Home care is dealing with
limited reimbursement and trying to keep the line ifunctional with out
interruptions to therapy. They can not go back frequently to restart a
Peripheral site, it is easier and quicker to have a PICC placed prior to
discharge. I f a PICC needs to be placed after discharge it involves a lot of
time to get orders, and make arrangements and often causes an interruption or
dealy in therapy .
Ann Marie
Ann Marie Parry RN
VITALine Home Infusion Pharmacy
Danville, PA
1-800-245-8767
570-271-5555 ext 54784
570-988-8447 pager
570-271-5843 fax
[EMAIL PROTECTED]
>>> "Nadine Nakazawa" <[EMAIL PROTECTED]> 8/15/2006 2:58 PM >>>
Does NHIA have a position on accepting patients for home infusion with just a
peripheral IV? It seems that ALL the home pharmacies we refer to REQUIRE
reliable venous access for home infusion, preferably a PICC line, unless it is
a one time infusion. There are always exceptions, but it seems to be a
general requirement. The PICC team is always under fire here to get that PICC
in so the patient can be discharged to home or alternate care facility.
Discharge is held off til the PICC is in and tip is confirmed.Nadine Nakazawa,
RN, BS, OCN
PICC Program Coordinator
Stanford University Hospital and Clinics
Stanford University Medical Center From: "Autym Didsbury" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED], [EMAIL PROTECTED]
Subject: Vanco infiltration
Date: Tue, 15 Aug 2006 09:25:19 -0600
BODY{margin-top:25px;font-size:10pt;margin-left:15px;color:#993300;font-family:Arial,
Helvetica;}Hi all-
I am coming to the group for a couple of suggestions. We continue to get
tremendous pressure from physicians to give peripheral vancomycin, phenergan,
and other potentially dangerous meds. In addition, the "powers that be" at our
agency are not supportive either- we are basically told to take whatever is
referred for fear of "alienating referral sources." (Yes, I know) To further
complicate the situation, I am not getting a lot of support from my infusion
pharmacy either- they are GREAT, but complacent with the issue of peripherals
despite the potential risk. Our "risk management" person is not a clinician,
and doesn't grasp the implications at all. What I am looking for is any
references specifc to vanco infiltration and potential complications, as well
as information regarding treating various extravasations. Any suggestions
would be greatly appreciated. The concept of appropriate vascular access
planning has not gained much ground in this community, and I am hopi!
ng that it doesn't take a disaster to get everyone's attention.
Thanks as always-
Autym Didsbury, RN, BSN, CRNI
Home Health Manager
Partners in Home Care
2687 Palmer St. Suite B
Missoula, MT 59808
(406) 327-3717 Fax 327-3727
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