1
|
Orford R, Slater P, Spencer B, Giarola T, Nicholls W, Walker R, Foresto S, Bradford N. One Hundred Times Better, at Home in Our Own Beds: Implementation of Home Intravenous Hydration After Chemotherapy in Children With Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:265-276. [PMID: 37017002 DOI: 10.1177/27527530221147880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Background: Home-based cancer care offers new ways of delivering supportive therapies, including post-chemotherapy hydration, traditionally delivered in hospital settings. Understanding how programs are developed and how parents perceive managing care at home offers opportunities to improve services and experiences. Aim: To describe the implementation process and evaluation of a home intravenous hydration program for children with cancer and thus to provide practical information for future initiatives. Methods: Data were prospectively collected on clinical impact, safety indicators, and estimated costs; these were tabulated and analysed. Semi-structured interviews were undertaken with a subset of parents regarding their experience and analysed using content analysis. Results: Over 34 months, 21 children were eligible, and 16 parents were educated and assessed competent with providing home care. All 16 children received home hydration with a median of 5.5 days per child (IQR 6.65 days). This avoided 116 hospital bed-days and associated costs, at an estimated total value of USD $ 105,521, on average saving USD $ 910 per day and USD $ 6,596 per child. There were no adverse events reported, and no child required re-admission to hospital while receiving home hydration. Parents were overwhelmingly positive in their feedback about the program. Verbatim quotes were synthesized under one overarching theme-supporting normality promotes recovery. Conclusion: When adequately trained and well supported, parents highly value providing home-based care to their children. This offers opportunities to improve experiences and outcomes for children and families as well as reduce costs to health services, achieving clinical impact without reducing safety.
Collapse
Affiliation(s)
- Rebekah Orford
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital, and Health Service, South Brisbane, Australia
| | - Penelope Slater
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital, and Health Service, South Brisbane, Australia
| | - Brooke Spencer
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital, and Health Service, South Brisbane, Australia
| | - Teghan Giarola
- Oncology Pharmacy, Queensland Children's Hospital, Children's Health Queensland Hospital, and Health Service, South Brisbane, Australia
| | - Wayne Nicholls
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital, and Health Service, South Brisbane, Australia
| | - Rick Walker
- Queensland Youth Cancer Service, Queensland Children's Hospital, Children's Health Queensland Hospital, and Health Service, South Brisbane, Australia
| | - Steven Foresto
- Oncology Services Group, Queensland Children's Hospital, Children's Health Queensland Hospital, and Health Service, South Brisbane, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research and School of Nursing, Queensland University of Technology, South Brisbane, Australia
| |
Collapse
|
2
|
Alamer F, Alanazi AT. The Impact of Smart Pump Technology in the Healthcare System: A Scope Review. Cureus 2023; 15:e36007. [PMID: 37051011 PMCID: PMC10085524 DOI: 10.7759/cureus.36007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 04/14/2023] Open
Abstract
Smart infusion pump technology prevents errors caused by parenteral therapy. This paper aims to review the recent literature about smart pump uses, cases and adverse events, and strategies to minimize these disadvantages. Literature was explored from January 2000 to November 2021 using Google Scholar, PubMed, and ScienceDirect. There were assessments of the advantages and adverse effects of using smart pumps and strategies to overcome the adverse effects of smart pumps. The advantage of using smart pumps is that they decrease errors like incorrect rate and dose. Other benefits include a decrease in medication event rates and the ability to connect smart pumps to home health providers. However, compliance rates were negatively influenced by improper smart pumps and the overriding of soft alerts, which can cause alert fatigue and drug library update delays. Recent studies have tried to address the negative issues by improving drug library compliance and decreasing alerts to avoid alert desensitization. The investigations revealed that the smart pumps reduced errors but would only prevent some programming errors. Compliance with utilizing smart pump technology is critical in stopping medication errors. Opportunities for future improvement are broad, including integrating a smart pump infusion with the hospital system, implementing auto programming, and designing smart pump devices to be lighter, smaller, and more portable instead of the heavy, large smart pump used by most hospitals today.
Collapse
Affiliation(s)
- Fatimah Alamer
- Health Informatics, King Saud Ibn Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdullah T Alanazi
- Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research, King Abdullah International Medical Research Center, Riyadh, SAU
| |
Collapse
|
3
|
Sharp R, Xu Q, Corsini N, Turner L, Altschwager J, Marker J, Ullman A, Esterman A. Community-based Intravenous Treatment and Central Venous Access Devices: A Scoping Review of the Consumer and Caregiver Experience, Information Preferences, and Supportive Care Needs. J Community Health Nurs 2023; 40:28-51. [PMID: 36602775 DOI: 10.1080/07370016.2022.2081506] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Map existing research and describe the consumer/caregiver experience of community-based intravenous treatment, central venous access devices (CVADs), supportive care needs, and information preferences. DESIGN Scoping review. METHODS Five databases (Joanna Briggs Institute, Cochrane library, Emcare, Embase, and Medline) were searched. Screening and data extraction were performed independently by two reviewers. FINDINGS Forty-eight studies were included. CONCLUSIONS Although community-based intravenous treatment and CVADs have a significant impact on consumers and caregivers, there is scant research on their supportive care needs and information preferences. CLINICAL EVIDENCE Some consumers and caregivers may require additional support while undergoing community-based intravenous treatment.
Collapse
Affiliation(s)
- Rebecca Sharp
- Clinical & Health Sciences, University of South Australia, Adelaide, Australia.,Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, Australia
| | - Qunyan Xu
- Clinical & Health Sciences, University of South Australia, Adelaide, Australia
| | - Nadia Corsini
- Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, Australia
| | - Lisa Turner
- Clinical Operations, Silver Chain Group, Australia
| | | | - Julie Marker
- Cancer Voices South Australia, Adelaide, Australia
| | - Amanda Ullman
- Children's Health Queensland and Health Service/ School of Nursing, Midwifery and Social Work, The University of Queensland, Australia
| | - Adrian Esterman
- Clinical & Health Sciences, University of South Australia, Adelaide, Australia.,Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, Australia
| |
Collapse
|
4
|
The significance of home-based portable pump chemotherapy for family caregivers to newly diagnosed patients with acute myeloid leukemia: A qualitative thematic analysis. Eur J Oncol Nurs 2022; 61:102200. [DOI: 10.1016/j.ejon.2022.102200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/17/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022]
|
5
|
Home Infusion Therapy: Utilization Under the Medicare Part B Temporary Transitional Payment. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223221079630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Bipartisan Budget Act (BBA) of 20181 created a temporary transitional payment (TTP) through Medicare Part B, which establishes fee-for-service (FFS) payment for eligible home infusion suppliers when they furnish home infusion therapy (HIT) service visits by skilled professionals in a beneficiary’s home on the day of HIT drug administration. Payment varies by 3 condition-specific payment categories. The Centers for Medicare & Medicaid Services (CMS) implemented the TTP on January 1, 2019. The TTP ended when the permanent HIT benefit began on January 1, 2021. To better understand how beneficiaries utilized this benefit during the TTP period, we examine trends in HIT services utilization between January 2019 and December 2020. Despite being new, the HIT benefit showed only a slight ramp-up phase, with a stable level of visits evolving over the remainder of 2019 and early 2020. Utilization decreased during the COVID-19 public health emergency, especially for infusion drugs related to heart failure and cancer. Additionally, relative to the geographic distribution of the Medicare FFS population, HIT service visit users are concentrated in the mid-Atlantic states. HIT service visit users are more likely to be young, white or black, and urban dwelling, compared to the general Medicare FFS beneficiaries.
Collapse
|
6
|
Mikami Y, Umemoto Y, Hoekstra SP, Hori S, Iwahashi T, Mochida K, Kamijyo YI, Tajima F. A one touch clamp and rack smart pump reduces mobilisation time and perceived burden of clinical staff members in charge of acute phase rehabilitation. J Med Eng Technol 2021; 46:32-39. [PMID: 34542001 DOI: 10.1080/03091902.2021.1970840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The purpose of this study was to experimentally assess the effect of a one touch clamp and rack smart pump on the time needed for patient mobilisation and the clinical staff`s perceived burden associated with these procedures when compared with the traditional type infusion system. Participants were randomly assigned to one of three groups: Multi-layer rack group (MULTI), One-touch pole clamp group (ONE), and a Control group (CON). In CON, traditional type pumps were replaced from pole stands to pole stands. In MULTI, the smart pumps were replaced from multi-layer rack to multi-layer rack, and in ONE the smart pumps were replaced from pole stands to multi-layer rack. In each group, the subject round-transported the simulated patient and re-replaced the pumps. The time of both pump replacements and the transport time were significantly shorter in MULTI and ONE compared with CON (p < 0.0001). The perceived burden of the replacement and transport were all significantly lower in MULTI and ONE than CON (p < 0.0001). The one touch clamp and rack smart pump reduced the time needed and perceived burden of mobilisation. These findings are anticipated to translate into progression in the delivery of early mobilisation and ultimately rehabilitation outcomes.
Collapse
Affiliation(s)
- Yukio Mikami
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasunori Umemoto
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Sven P Hoekstra
- The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
| | - Shinnosuke Hori
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takaya Iwahashi
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kenji Mochida
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoshi-Ichiro Kamijyo
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.,Department of Rehabilitation Medicine, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.,The Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
| |
Collapse
|
7
|
Amicucci M, Ciaralli I. Nurse Practitioner Management of a Blinatumomab Infusion Program: Impact on Patient Safety and Quality of Care. JOURNAL OF INFUSION NURSING 2021; 44:34-40. [PMID: 33394872 DOI: 10.1097/nan.0000000000000409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The prognosis of children with acute lymphoblastic leukemia can be improved with the use of monoclonal antibodies such as blinatumomab. Many studies discuss the management and treatment of symptoms; however, none of them describe practical complications related to the continuous infusion of blinatumomab, especially during home-based therapy. The purpose of this study is to describe the experience gained over 4 years in the management of pediatric patients undergoing therapy with blinatumomab in an Italian tertiary hospital. The establishment of a nursing program dedicated to improving infusion pump management, patient support, quality of care, and patient safety will be discussed.
Collapse
Affiliation(s)
- Matteo Amicucci
- Bambino Gesù Children's Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Sant'Onofrio Square, Rome, Italy
- Matteo Amicucci, MSN, RN , is a research nurse on the haematology-oncology and cell and gene therapy service at Bambino Gesù Children's Research Hospital IRCCS, Sant'Onofrio Square in Rome, Italy
- Italo Ciaralli, RN , is a nurse coordinator on the haematology-oncology and cell and gene therapy service at Bambino Gesù Children's Research Hospital IRCCS, Sant'Onofrio Square in Rome, Italy
| | - Italo Ciaralli
- Bambino Gesù Children's Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Sant'Onofrio Square, Rome, Italy
- Matteo Amicucci, MSN, RN , is a research nurse on the haematology-oncology and cell and gene therapy service at Bambino Gesù Children's Research Hospital IRCCS, Sant'Onofrio Square in Rome, Italy
- Italo Ciaralli, RN , is a nurse coordinator on the haematology-oncology and cell and gene therapy service at Bambino Gesù Children's Research Hospital IRCCS, Sant'Onofrio Square in Rome, Italy
| |
Collapse
|
8
|
Implementation of Smart Infusion Pumps: A Scoping Review and Case Study Discussion of the Evidence of the Role of the Pharmacist. PHARMACY 2020; 8:pharmacy8040239. [PMID: 33339182 PMCID: PMC7768446 DOI: 10.3390/pharmacy8040239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 11/26/2022] Open
Abstract
“Smart” infusion pumps include built in drug error reduction software which uses a drug library. Studies have reported the drug library build should be undertaken by a multidisciplinary team, including a pharmacist; however, the extent or nature of the input required by the pharmacist for greatest benefit is unknown. This review aimed to identify key factors for the implementation of the smart infusion pumps, with a focus on the role of pharmacists and compare this to the experience from a case study. A literature review was conducted using Embase and Ovid Medline, and 13 eligible papers were found. Predominant themes relating to the pharmacist’s role and successful implementation of the smart infusion pumps were determined. Key factors for success included team involvement across the entire process from procurement, set-up through to implementation including risk assessment and device distribution, and training, which were comparable to the case study experience. Few studies described the extent or details of the pharmacist’s responsibilities.
Collapse
|
9
|
Vest TA, Gazda NP, Schenkat DH, Eckel SF. Practice-enhancing publications about the medication-use process in 2018. Am J Health Syst Pharm 2020; 77:759-770. [PMID: 32378716 DOI: 10.1093/ajhp/zxaa057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE This article identifies, prioritizes, and summarizes published literature on the medication-use process (MUP) from calendar year 2018 that can impact health-system pharmacy daily practice. The MUP is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The MUP is defined in this article as having the following steps: prescribing/transcribing, dispensing, administration, and monitoring. Articles that evaluated one of the steps were gauged for their usefulness toward daily practice change. SUMMARY A PubMed search was conducted in February 2019 for articles published in calendar year 2018 using targeted Medical Subject Headings (MeSH) keywords, targeted non-MeSH keywords, and the table of contents of selected pharmacy journals, providing a total of 43,977 articles. A thorough review identified 62 potentially significant articles: 9 for prescribing/transcribing, 12 for dispensing, 13 for administration, and 28 for monitoring. Ranking of the articles for importance by peers led to the selection of key articles from each category. The highest-ranked articles are briefly summarized, with a mention of why they are important within health-system pharmacy. The other articles are listed for further review and evaluation. CONCLUSION It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article assists in identifying and summarizing recent impactful contributions to the MUP literature. Health-system pharmacists have an active role in improving the MUP in their institution, and awareness of significant published studies can assist in changing practice at the institutional level.
Collapse
Affiliation(s)
- Tyler A Vest
- Duke University Hospital, Durham, NC, and University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC
| | | | | | - Stephen F Eckel
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, and University of North Carolina Medical Center, Chapel Hill, NC
| |
Collapse
|