Administerring 5-fu at home, urgent advice needed

[sailkeys]

Hello, I am a home health nurse that has been asked to give 5-fu to a patient at home. I have no chemotherapy background.

I am from Florida and have no idea if you need to be chemo certified to give this med, and cannot seem to find the information online.

Also, does anyone know anything about this chemotherapy or special considerations when administering 5-fu? I have no idea how to administer this chemotherapy.

Thank you for any advice that you can give me.

[msrosebud28]

I work for a home health company and we do chemo in home but we only hook up to the pump and take it down. We do not mix or program the pump . The pharmacy mixes and programs the pump , we only check for correct settings. And for this reason I am told is why we do not have to be certified.

[LISABOLTON]

We are having the same situation in PA - as of July1st Medicare will not pay for the start of chemotherapy agents at the oncology office. Our owner/president of the company (who daughter happens to be the consulting pharmacist) is telling us that it is perfectly safe to start the chemotherapy agent in the home setting via a port-a-cath/CAAD pump. I can not find any information on-line which states we NEED to be certified - HELP!!!!

[nutella, MSN, RN]

I worked in home palliative /hospice and did 5 - FU in home. In my state it is perfectly legal to administer 5 FU when all the requirements are met.

The way it works is that the oncologist orders the chemo and faxes the order to the outside pharmacy/company that mixes the drug. The company delivers everything home. Often the patient get another chemo in center so that the VAD is already accessed. If there is no other chemo before that, you need to access the VAD. There is a protocol for that - access, maintenance and de-access. And you need training and get signed off on the skill. You go through some steps before starting the chemo including pat assessment, verify the chemo order with the medication and so on and forth, load the CADD and verify the pump setting.Connect the chemo to the patient. Once started I would do the usual teaching (flushing the toilet twice, safey , what if pump becomes disconnected/makes noise and so on, medication to use prn nausea/vomiting/diarrhea , who to call with problems. After 15 minutes you need to take another set of VS. oh and you will have to gown and glove up with chemo precautions. Most of my pat would run chemo for 46 hours, once a while somebody would run over 5 days.

The most important thing is to always verify everything and never skip a step! also, make sure the labs were ordered before and signed off to be ok by the physician who ordered the chemo. Problems I have encountered are related to VAD, medication bag not ok, pump not ok, patient disconnected by accident...

Oh -if the pharmacy sends out a pump that is not programmed correctly, do not let them talk you into programming it at home over the phone- there is no 2.nd person to verify.

Make sure you have all policy and procedures, received all teaching and have info hand outs.

oh yeah - make sure your patients understand when to call.

The company that supplies the chemo and equipment sents out the nurse to educate on 5 FU and does teaching - perhaps your company will do something like that.