The department director over our home care, hospice, and home infusion pharmacy is pushing us to promote infusing remicade in the home setting. I am a bit leary of this after seeing what our courier went through with his infusions in the out-patient setting. How many of you do these infusions in the home and have you had any issues during these infusions. It got to the point where our courier's infusion would last 6 or more hours even after premedication. Thanks for any feedback. Valorie
Valorie Dunn, RN, BSN, CRNI
I find it very interesting that no one from home care has responded to this message. My understanding is that Remicade is most often infused in a controlled setting such as an infusion clinic. I would be concerned about the patient safety in home care if infusion reactions occur. So the home care nurse would need to remain with the patient during the infusion time and I don't think this would be cost effective. I am giving a 3-hour workshop at the Rheumatology Nurses Society annual conference in a few weeks and the most common setting they are interested in is infusion via peripheral veins in clinics, doctors offices, and other ambulatory settings. I am also curious as to why this director thinks home care would be safe and appropriate for these patients. Are these patients now being infused in an ambulatory infusion clinic? Is there concern about length of infusion requiring too much "chair time" prohibiting quick turnover for other patients and decreasing profitability? Some other reasons or issues that I am overlooking? Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Lynn, Thanks for your response. Our director thinks it is save even though I totally disagree. She feels the revenue would make it worth while no matter how long the nurse had to stay with the patient. We have a new GI doc in the area requesting this be done in the home. I am refusing becaue I am like you, this needs to be done in a setting that is more prepared for the reactions.
Valorie Dunn, RN, BSN, CRNI
Valorie Dunn,BSN, RN, CRNI, PLNC