Development of Policy and Procedure for the Use of Alteplase for Occluded Central Venous Catheters in a Home Infusion Population

2.50
Hdl Handle:
http://hdl.handle.net/10755/164935
Category:
Abstract
Type:
Presentation
Title:
Development of Policy and Procedure for the Use of Alteplase for Occluded Central Venous Catheters in a Home Infusion Population
Author(s):
Carsello, Janice; Peoples, Lynda; Michael, Martha; Moore, Teresa
Author Details:
Janice Carsello, RN, BSN, CRNI, OCN, Clinical Nurse III, Thomas Jefferson University Hospital - Jefferson Home Infusion Service, Philadelphia, Pennsylvania, USA, email: nurscarp1@comcast.net; Lynda Peoples, RN, BSN, CRNI; Martha Michael, RN, BSN, CRNI; Teresa Moore, RN
Abstract:
Clinical/Evidence Based Practice: Millions of central venous catheters (CVCs) are inserted each year in the United States, allowing patients to receive a wide variety of complex therapies in many settings. These therapies include total parenteral nutrition (TPN), intravenous antibiotics, chemotherapy, and hydration. A frequent challenge to maintaining these therapies over prolonged periods of time is CVC occlusions (complete or partial). Jefferson Home Infusion Service (JHIS) found it increasingly difficult to schedule our patients with occluded CVCs for timely intervention in the hospital/outpatient setting. JHIS needed to devise a safe and cost effective solution to manage this significant issue. JHIS nursing staff presented the issue to our internal quality assurance committee and a sub-committee was formed. The group examined the issues of patient safety, insurance reimbursement, drug stability/delivery and nursing availability. After reviewing the relevant literature, policy and procedure documents were developed and in-services were scheduled for all staff members. JHIS intake department devised a plan for obtaining insurance reimbursement. A step-by-step guide was created for use by all JHIS nursing and pharmacy staff. This algorithm is followed whenever a patient presents with an occluded CVC. Our clinical staff has welcomed the idea of being able to manage this CVC complication in the patient's home. Patients are happy to learn that they will not have to return to the hospital or outpatient setting unless our at-home intervention is unsuccessful. The practitioners who prescribe therapies for our patients continue to remain confident that JHIS is providing cutting-edge, quality care for their patients. Alteplase is widely utilized in the hospital/outpatient infusion setting to treat CVC occlusions. This CVC complication can effectively be managed at home by skilled home infusion nurses. Our success can inspire other infusion nurses to adopt similar policies/procedures for their organizations.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDevelopment of Policy and Procedure for the Use of Alteplase for Occluded Central Venous Catheters in a Home Infusion Populationen_GB
dc.contributor.authorCarsello, Janiceen_US
dc.contributor.authorPeoples, Lyndaen_US
dc.contributor.authorMichael, Marthaen_US
dc.contributor.authorMoore, Teresaen_US
dc.author.detailsJanice Carsello, RN, BSN, CRNI, OCN, Clinical Nurse III, Thomas Jefferson University Hospital - Jefferson Home Infusion Service, Philadelphia, Pennsylvania, USA, email: nurscarp1@comcast.net; Lynda Peoples, RN, BSN, CRNI; Martha Michael, RN, BSN, CRNI; Teresa Moore, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164935-
dc.description.abstractClinical/Evidence Based Practice: Millions of central venous catheters (CVCs) are inserted each year in the United States, allowing patients to receive a wide variety of complex therapies in many settings. These therapies include total parenteral nutrition (TPN), intravenous antibiotics, chemotherapy, and hydration. A frequent challenge to maintaining these therapies over prolonged periods of time is CVC occlusions (complete or partial). Jefferson Home Infusion Service (JHIS) found it increasingly difficult to schedule our patients with occluded CVCs for timely intervention in the hospital/outpatient setting. JHIS needed to devise a safe and cost effective solution to manage this significant issue. JHIS nursing staff presented the issue to our internal quality assurance committee and a sub-committee was formed. The group examined the issues of patient safety, insurance reimbursement, drug stability/delivery and nursing availability. After reviewing the relevant literature, policy and procedure documents were developed and in-services were scheduled for all staff members. JHIS intake department devised a plan for obtaining insurance reimbursement. A step-by-step guide was created for use by all JHIS nursing and pharmacy staff. This algorithm is followed whenever a patient presents with an occluded CVC. Our clinical staff has welcomed the idea of being able to manage this CVC complication in the patient's home. Patients are happy to learn that they will not have to return to the hospital or outpatient setting unless our at-home intervention is unsuccessful. The practitioners who prescribe therapies for our patients continue to remain confident that JHIS is providing cutting-edge, quality care for their patients. Alteplase is widely utilized in the hospital/outpatient infusion setting to treat CVC occlusions. This CVC complication can effectively be managed at home by skilled home infusion nurses. Our success can inspire other infusion nurses to adopt similar policies/procedures for their organizations.en_GB
dc.date.available2011-10-27T12:09:36Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:09:36Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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