New model for patient care- Hospital at home - page 2
This new model of patient care (explained at clinicallyhome.com) allows patients who have easily treatable diseases such as pneumonia, DVT, asthma and cellulitis to stay home under the program... Read More
1Mar 29, '13 by LadyFree28, BSN, RNQuote from anon456^That really should have not happened.I was amazed and kinda shocked when the child of a friend, who had suffered a severe ruptured appy and was on TPN/Lipids for a time, was sent home with a PICC. Her parents were instructed how to clean the port, plug in the pump, and infuse antibiotics a couple of times a day! The parents said they were uncomfortable with this but they felt pressured by insurance and doctors to agree to it. There was no nurse involved- they were to take the child to a clinic to change the dressing. The child ended up suffering toxicity from one of the antibiotics because her labs were not being watched as closely as they would have been in the hospital. She was okay in the end, but it really made me think about all the potential risks of things going very bad.
We have several patients who have home PICC lines who have come in, and 9 times out of 10 the dressings look awful. The broviacs are not coiled up totally under the dressing, the dressing is half-off or soiled with stool, and the child is coming in for a fever. Hmmm . . . ? I am told in some cases that a home nurse comes once a week to change the dressing-- but apparently the dressings are not inspected daily in between.
There should've at least been an company still assisting and advocating to make sure that labs were drawn, if the dressing got soiled in any way that a culture can be obtained and a dr's appointment made right away. That is usually the protocol on pt's going home with a central line or long-term abx therapy; they are still monitored; whether the insurance company (telehealth and HH division), hospital (their HH division), or HH agency is involved, there is ALWAYS someone able to do a visit and get out to make sure that the complications are minimized.