Slayt 1 - Cureus
Transkript
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.