pharmacy 483 institutional and healthcare systems home care programs jeff purcell pharm.d....
Post on 21-Dec-2015
215 views
TRANSCRIPT
![Page 1: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/1.jpg)
Pharmacy 483Institutional and Healthcare Systems
Home Care ProgramsJeff Purcell Pharm.D.
![Page 2: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/2.jpg)
Home Care Programs
• Home Infusion Service**
• Home Nursing Service
• Home Respiratory Service
• Home Physical/Occupational Therapy
• Home Hospice Service
![Page 3: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/3.jpg)
Home Infusion Services
• IV Antimicrobials
• IV Fluids
• Total Parenteral Nutrition
• Tube Feedings
• Parenteral Pain Management
• IV Cancer Chemotherapy
![Page 4: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/4.jpg)
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?
![Page 5: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/5.jpg)
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?
![Page 6: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/6.jpg)
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?
![Page 7: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/7.jpg)
IV Antimicrobials Other Issues
• Acceptable home setting?
• Acceptable patient abilities/habits?
• Acceptable caregiver for help?
• Acceptable IV access?
• Acceptable funding?
![Page 8: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/8.jpg)
IV Fluids Assessment
• Acceptable home setting?
• Acceptable patient abilities/habits?
• Acceptable caregiver for help?
• Acceptable IV access?
• Acceptable funding?
![Page 9: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/9.jpg)
Total Parenteral Nutrition
• Acceptable home setting?
• Acceptable patient abilities/habits?
• Acceptable caregiver for help?
• Acceptable IV access?
• Acceptable funding?
• Acceptable follow-up with physician?
![Page 10: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/10.jpg)
Tube Feeding Assessment
• Acceptable home setting?
• Acceptable patient abilities/habits?
• Acceptable caregiver for help?
• Acceptable access tube?
• Acceptable funding?
• Acceptable mode of administration?
![Page 11: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/11.jpg)
Parenteral Pain Management
• Acceptable home setting?
• Acceptable patient abilities/habits?
• Acceptable caregiver for help?
• Acceptable IV/SC access?
• Acceptable funding?
![Page 12: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/12.jpg)
Home Cancer Chemotherapy
• Acceptable home setting?
• Acceptable patient/care giver abilities?
• Acceptable caregiver for help?
• Acceptable IV access?
• Acceptable funding?
• History of tolerating chemo?
![Page 13: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/13.jpg)
Infusion Pumps
TPN Pump
PCA Pump
Continuous/bolus
Multipurpose pump
![Page 14: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/14.jpg)
IV Access Devices
Peripheral Catheter
![Page 15: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/15.jpg)
IV Access Devices
PICC-Peripherally Inserted Central Catheter
![Page 16: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/16.jpg)
IV Access Devices
Groshong Catheter
![Page 17: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/17.jpg)
IV Access Devices
Implanted Ports
![Page 18: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/18.jpg)
ADD-vantage type vials
![Page 19: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/19.jpg)
ADDvantage type bags
![Page 20: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/20.jpg)
ADDvantage system-Mixing
![Page 21: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/21.jpg)
Elastomeric Infuser
![Page 22: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/22.jpg)
Syringe Pump
![Page 23: Pharmacy 483 Institutional and Healthcare Systems Home Care Programs Jeff Purcell Pharm.D. jbp@u.washington.edu](https://reader035.vdocument.in/reader035/viewer/2022062714/56649d6a5503460f94a4842d/html5/thumbnails/23.jpg)
Home Infusion Systems
• Proprietary private
• Internal hospital based
• HMO based