Abstract

Working in a large oncology hospital, central venous catheters are indispensable devices in which to deliver chemotherapy regimens and other supportive care medication administration. The necessity for a central venous catheter (CVC) initiates a patient education process that requires informing, educating and preparing the patient for the insertion and post-management requirements.

It is crucial to organize and plan the strategies necessary to meet the needs of patients in a timely manner, decrease cost, and improve patient outcomes. By interviewing patients prior to a CVC placement, patients can be better prepared for the procedure, learning needs can be identified and patient education can begin. Patients and family members view the “Informed Consent” video, which explains the insertion procedure, risk, benefits, alternatives, possible complications and catheter care requirements. This article will focus on how the need for the interview process was identified and implemented and the format for an interview.

ABSTRACT

Although case management is now well established within many areas of healthcare, its use in home infusion remains sporadic and largely undocumented. Few published examples exist in the literature. At the same time, home care professionals remain under intense pressure to provide high quality and often technically complex care in a cost-effective manner. Case management has been proposed as a method for achieving this goal in home infusion. This, article describes two current models, acute and chronic, of case management. They are discussed in terms of the Case Management Society of America's basic program definition and present how adaptations of the basic definition function to meet the specific patient needs in home infusion.

Abstract

Immunologic Heparin-induced Thrombocytopenia (HIT Type II) results from heparin exposure in any form, and can result in major intravascular thrombotic events, ischemia, and death. Type II HIT occurs in approximately 1 to 3% of patients receiving heparin and can occur at any dose or via any route of administration, making it a potentially serious complication of routine central venous access device (CVAD) maintenance with heparin flush locking techniques. A review of the clinical literature reveals largely anecdotal information implicating the role of heparin flush solutions in its development. Further study is needed to more specifically identify the likelihood of developing HIT from vascular access device related causes.