Infusion Program Updates
The Vancouver Hospital Infusion Program
February 1999 Drug & Therapeutics Newsletter
(C) 1999, CSU-Pharmaceutical Sceinces
Vancouver Hospital & Health Sciences Centre
Did you know that...
The Home IV Antibiotic Program has been operating successfully for over 36 months, has enrolled over 265 patients who received over 6,200 outpatient antibiotic treatment days.
A 1997 13-month cost benefit analysis of the Home IV Antibiotic Program revealed an estimated net cost avoidance of over $440,000. In other words, for every 12 cents VHHSC contributes to the program, a cost avoidance of $1.00 is achieved.
All patients who are enrolled into the Home IV Antibiotic Program are asked to complete a satisfaction survey at the end of treatment. A 1998 18-month analysis of surveys revealed that on a 10-point scale, the median rank of patient satisfaction with the program is 10. In fact, 95% of patients enrolled in the program state they would participate again if the need arose.
Infusion Device Facts and Tips:
Mechanical phlebitis is the most common side effect of a newly inserted PICC. It will appear within 72 hours and usually resolves well with moist, continuous heat for 24 hours.
The primary cause of a "positional" PICC is a twisted or kinked line between the suture wing and the PICC hub.
A PICC dressing will always have a gauze dressing under the occlusive dressing for the first 24 hours only (for occasional bleeding); subsequent dressings will only have the occlusive dressing.
A gauze dressing should not be placed under an occlusive dressing for longer that 24 hours as it traps heat and moisture and will increase the risk of infection.
If you see fluid under an occlusive dressing, check to see that the extension tubing is firmly attached to the PICC hub.
When doing IV/CVC site preparation, use firm pressure, moving from the centre outwards.
Following the removal of a CVC, the best dressing to apply is a gauze and occlusive dressing. These should be removed again in 24 hours.
Four benefits of a Groshong close-ended catheter are that no heparin flush is required, no clamp is necessary, bleeding from the catheter is unlikely and air emboli is extremely uncommon .
Huber point needles are now available in a 20 gauge, 3/4" length for leaner patients. This size is adequate for blood withdrawal and administration of medications.
A patient teaching booklet entitled "Total Parenteral Nutrition - A guide for Patients and Their Families" is available for distribution and can be ordered from Lori Mason at local 5-4469.