Slayt 1 - Cureus

INFUSION NURSING AT HOME
Yrd.Doç.Dr.Nurgül GÜNGÖR TAVŞANLI
HEALTH SCHOOL OF CELAL BAYAR UNIVERSITY
Intravenous infusion means intravenous application of exceeding amounts of drugs or solutions by injection
or catheter. It is used if the patient does not have the possibility to be treated orally. When the drug is
applied in form of infusion it is given to the patient by a certain period (short or long) and speed. In the
methods of intravenous treatment, the drug can be injected directly into the vein or by Bolus technology
putting the drugs in 500-1000 ml. serums.
Nowadays especially the patients having chronic diseases want to be treated at home. To
meet the patients’ complex health requirements, curing at home services by maintaining
infusion reatments is done.
•It is anticipated that infusion treatment at home will decrease the time of staying in
hospital
•decrease the risk of infection,
•decrease the treatment costs of chronic diseases by preventive health services,
•decrease the invisible costs (companion, transportation expenses, labor costs, etc.)
by incorporation of patient relatives,
The areas where infusion treatment
usually applied are;
•remove the costs that arise from the problems of relatives,
•decrease the return to the hospital,
•emergency department or intensive care services.
The role of the home-care nurse
The role of the home-care nurse is being a
coordinator and support person for the patients. She is
STANDARDS FOR İNFUSİON THERAPY
1. Education and training
5. Site selection and placement
1.1 Staff education
5.1 Site selection
1.2 Patient and caregiver education
5.2 Device selection
2. Infection control and safety compliance 5.3 Hair removal
2.1 Infection control
5.4 Local anaesthesia
2.2 Hand-washing 1
5.5 Insertion site preparation
2.3 Personal protective equipment (PPE)
5.6 Device placement
2.4 Reconstitution
5.7 Device stabilisation
2.5 Compatibility
5.8 Dressings
2.6 Expiry dates
6. Site care and maintenance
2.7 Safe use and disposal of sharps and
6.1 Site care
hazardous material
6.2 Maintaining patency
2.8 Cleaning and sterilising reusable
6.3 Catheter clearance
equipment
6.4 Vascular access device
3. Products and documentation
removal
3.1 Product requirements
6.5 Catheter malposition
3.2 Product defect reporting
6.6 Catheter exchange
3.3 Labelling 15
6.7 Catheter repair
3.4 Patient safety incidents
7. Specific devices
3.5 Research, audit and benchmarking
7.1 Intrapleural catheters
3.6 Documentation
7.2 Arteriovenous fistulae, shunts
4. Infusion equipment
and haemodialysis catheters
4.1 Add-on devices
7.3 Cutdown surgical sites
4.2 Splints
7.4 Intraosseous access
4.3 Filters
7.5 Subcutaneous
4.4 Flow control devices
injection/infusion
4.5 Blood/fluid warmers
(hypodermoclysis)
4.6 Injection and access caps/ports
7.6 The Ommaya reservoir (an
4.7 Tourniquets
intraventricular access device)
4.8 Administration sets
Kaynak: Royal college of nursing, Standards for
infusion therapy, The RCN IV Therapy Forum, Third
edition, January 2010.
responsible for briefing the essential staff for providing
8. Infusion therapies
8.1 Medication and solution
administration
8.2 Intrathecal chemotherapy
administration
8.3 Oncology and chemotherapy
8.4 Patient-controlled analgesia
8.5 Parenteral nutrition
8.6 Transfusion therapy
8.7 Intravenous conscious
sedation
8.8 Epidural analgesia infusion
8.9 Intravenous immunoglobulin
therapy
8.10 Apheresis procedures
(donor/therapeutic)
8.11 Blood sampling
9. Infusion-related complications
9.1 Phlebitis
9.2 Infiltration
9.3 Extravasation
9.4 Haematoma
9.5 Haemorrhage
9.6 Pneumothorax and
haemothorax
9.7 Cardiac tamponade
9.8 Air embolism
9.9 Speedshock/fluid overload
9.10 Infusion-related
bloodstream infections
9.11 Thrombosis
KAYNAKLAR
•Ay Akça F, Ertem Turan Ü, Özcan Keser N, Güneş B, Işık Demir R., Savran S (2007). “Temel Hemşirelik Kavramlar, İlkeler, Uygulamalar” , İstanbul Medikal Yayıncılık, 1.Baskı, s: 348-350.
•Cox ve ark. (2007). Home Intravenous Antimicrobial Infusion Therapy: Aviable Option in Older Adults, J Am Geriatr Soc 55:645–650.
•Duke M., Street A (2003). Hospital in the home: constructions of the nursing role – a literature review, Journal of Clinical Nursing, 12: 852–859.
•Ertem G (2010). Jinekolojik kanserlerde evde bakım, Türk Onkoloji Dergisi, 25(3):124-132.
•Ewers M. (2002). The Advent of High-Tech Home Care in Germany, Public Health Nursing Volume 19 Number 4 July/August, pp. 309–317.
•Graves D B (1995). Home Infusion Therapy, Nursing Management / Vol 26 No. 8, August, pp:32j-32p.
•Gugerty B (2006). The Holy Grail:Cost-Effective Healthcare Evidence Transparently and Consistently Used by CliniciansJournal of Healthcare Information Management, Volume 20, Number 3, pp:21-24.
•Infusion Nurses Soceity – INS (2011). 22 Temmuz 2011 'de http://www.ins1.org adresinden indirildi.
•Infusion Nursing Certification Corporation - INCC (2011). 22 Temmuz 2011 'de http://www.incc1.org/i4a/pages/index.cfm?pageid=3321 adresinden indirildi.
•Madeline M., Lorentz B A (2008). Home Healthcare Nurse April, vol. 26, no. 4, pp 237-243.
•Milli Eğitim Bakanlığı [MEB] (2011). Ortaöğretim Projesi, Anestezi ve Reanimasyon, İntravenöz sıvı infüzyonu, Ankara, s:15-37.
•National Home Infusion Assocation [NHIA] (2011), About Infusion Therapy, 22 Temmuz 2011 'de http://www.nhia.org/about-home-infusion.cfm adresinden indirildi.
•NHE - The National Health Expenditures (2009). National Health Expenditure Projections 2009-2019 (September 2010). 20Ağustos 2011'de
https://www.cms.gov/NationalHealthExpendData/downloads/NHEProjections2009to2019.pdf adresinden indirildi.
•Oran T N (2006). Evde İnfüzyon Tedavisi, Evde Bakım, İzmir, Meta Basım Matbaacılık Hizmetleri, s: 95-110.
•Özsarı H (2011). “Evde Sağlık Hizmetlerinde Maliyet Etkililik”, 1.Uluslararası Evde Sağlık Kongresi 8-9 Nisan, Maritim Pine Beach Hotel, Belek-Antalya.
•Rice R (2006 ). The Patient Receiving Home Infusion Therapies, Home Care Nursing Practice: Concepts and Application, Fourth Edition, Mosby Elsevier, USA, pp: 381-402.
•Royal college of nursing, Standards for infusion therapy, The RCN IV Therapy Forum, Third edition, January 2010.
high technological services. Nurses at home must have
the goods and be well-quipped to take care of catheters
and maintenance of treatment. Period of home caring
visits must be organized according to patient needs.
Other than home visits, home caring services must go
on 24 hours for emergency conditions.
These days of becoming widespread of home caring services in our
country, a certification programme must be prepared to standardise the
applications, post-graduate programmes must be opened to raise
experts of at home caring services, guides must be prepared. Infusion
Nurses Society (INS) established at 1973, Infusion Nursing Certification
Corporation (INCC) established at 1983, are the foundations that serve
internationally in this area of work.