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Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D.

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Presentation on theme: "Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D."— Presentation transcript:

1 Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu

2 Home Care Programs Home Infusion Service** Home Nursing Service Home Respiratory Service Home Physical/Occupational Therapy Home Hospice Service

3 Home Infusion Services IV Antimicrobials IV Fluids Total Parenteral Nutrition Tube Feedings Parenteral Pain Management IV Cancer Chemotherapy

4 IV Antimicrobials Clinical Issues Appropriate medication for organism? Appropriate dose of medication? Appropriate frequency for home? Can the patient take oral equivalent? Appropriate monitoring available?

5 Patient : JP, 48 yo male with fever Enterococcus faecalis in blood 3/4 PASV PICC placed in L. arm Plan to discharge on Ampicillin 2gm q4h IV Problems? Solutions?

6 Patient: 49 yo male with fever Med History: many admits for skin abscess Social: IVDU x30 years Lives with friends Bacteremic with MRSA, 6/6 bottles Plan: home with Vancomycin 1gm IV q12h x28 Problems? Solutions?

7 IV Antimicrobials Other Issues Acceptable home setting? Acceptable patient abilities/habits? Acceptable caregiver for help? Acceptable IV access? Acceptable funding?

8 IV Fluids Assessment Acceptable home setting? Acceptable patient abilities/habits? Acceptable caregiver for help? Acceptable IV access? Acceptable funding?

9 Total Parenteral Nutrition Acceptable home setting? Acceptable patient abilities/habits? Acceptable caregiver for help? Acceptable IV access? Acceptable funding? Acceptable follow-up with physician?

10 Tube Feeding Assessment Acceptable home setting? Acceptable patient abilities/habits? Acceptable caregiver for help? Acceptable access tube? Acceptable funding? Acceptable mode of administration?

11 Parenteral Pain Management Acceptable home setting? Acceptable patient abilities/habits? Acceptable caregiver for help? Acceptable IV/SC access? Acceptable funding?

12 Home Cancer Chemotherapy Acceptable home setting? Acceptable patient/care giver abilities? Acceptable caregiver for help? Acceptable IV access? Acceptable funding? History of tolerating chemo?

13 Infusion Pumps TPN Pump PCA Pump Continuous/bolus Multipurpose pump

14 IV Access Devices Peripheral Catheter

15 IV Access Devices PICC-Peripherally Inserted Central Catheter

16 IV Access Devices Groshong Catheter

17 IV Access Devices Implanted Ports

18 ADD-vantage type vials

19 ADDvantage type bags

20 ADDvantage system-Mixing

21 Elastomeric Infuser

22 Syringe Pump

23 Home Infusion Systems Proprietary private Internal hospital based HMO based

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