Friday, August 26, 2011

Nontraditional- Home Infusions

Posted by Anna Polk at Friday, August 26, 2011

I spent my first rotation at HomeMed in Ann Arbor. It was a last minute addition after some trouble with my originally scheduled rotation (I didn’t find out where I would be going until orientation). In the end, though, I couldn’t be happier about the way things worked out!

I really had no idea what to expect, but I came to realize that no two days are ever the same in Home Infusions! One day you could be waiting on all of your patients to see if they were going to discharge and the next they could suddenly discharge all at once and you’d have to scramble to get their orders ready. Your plan for the day could quickly change with the addition of a new referral or changes in your existing patients so you definitely have to be flexible.

The bulk of the patients serviced by HomeMed are on an extended course of IV antibiotics, TPN or chemotherapy. There are a few other therapies as well- such as IVIG. I didn’t realize how much clinical work was involved in Home Infusions. When a patient is initially referred, we do an initial assessment and we create care plans for the patient. If the ordering physician requested lab work to be done we follow up on the results and make assessments for any required therapy changes. It was such great practice for learning what needs to be monitored and how often.

Finally, I learned how important communication is between all of the different healthcare providers! A HomeMed order is usually handled by the ordering physician, the discharge planner, someone who verifies their insurance, the pharmacist, technicians to create their labels and supply lists and then more technicians to compound the order, pickers and packers in the warehouse and then it goes out for delivery. Great care has to be taken to ensure that nothing falls through the cracks! There are also nurses involved at the cancer center, nurses who train the patients while they are inpatients and nurses who go out to the patients’ homes for administration.

So- one down and eight to go! Next up is my community HIV/AIDS rotation in Chicago- I’m actually about to go pack right now!

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