Home Health Cardiac Nursing

[graco]

I am the DON of a small TX agency. With the cutbacks on everything, the area hospitals are trying to get the patients out of the dorr faster and sicker. the recent request has been for home monitoring and maintenance of patients with chronic cardiac/CHF on primacor, dopamine, & dobutamine. I have done home health cardiac nursing before, but nothing this involved. Do any of you have any experience with this? If so, let me know your ideas and the pros/cons. Thanks

[teamrn]

I just 'happenned' by your message and thought I'd respond. I'm a hopsice nurse, most of our patients are oncology, cardiac, respiratory, and dementia; either way, the treatment plans for them is not an aggressive one. Having said that, we have had 1 or 2 end stage cardiac disease patients who have had dobutamine drips at home. I was not their case manager, but if I remember correctly, the dobutamine labs were MUCH less frequent/if at ALL, and the dobutamine was titrated per symptoms. The physician and case manager(herslf an experienced cardiac nurse) felt that dobutamine was indicated for quality of life, so it was done. Patients and families generally then make up their minds once home, that they no longer WANT to continue with what they consider an aggressive form of treatment, and then they're receptive to discontinuing the med. However, I guess what i'm trying to say(got lon-winded there) was that it CAN be done. There must be a home health site on the 'net. If not, let me know, as I've some friends in HH who may have thoughts.