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Evaluating Home Health Intravenous Infusion Referrals

Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional: September 2010 - Volume 28 - Issue 8 - p 496–498
doi: 10.1097/NHH.0b013e3181e2caef
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Evaluating Home Health Intravenous Infusion Referrals


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GENERAL PURPOSE: To provide registered professional nurses with information to assist in the evaluation of the appropriateness of intravenous infusion referrals.


After reading this article and taking this test, you should be able to:

  1. Outline the background information essential for understanding the issues involved in making the decision to accept an infusion referral.
  2. Plan the appropriate strategies for deciding to accept an infusion referral and for following through with the patient's care.

1. According to Cox and colleagues, nearly what percentage of patients studied who received IV antibiotics via home infusion developed catheter-related complications?

a. 18%

b. 28%

c. 38%

d. 48%

2. O'Halloran and colleagues reported that about what percentage of patients with PICC lines or peripheral intravenous lines experienced a complication?

a. 20%

b. 30%

c. 40%

d. 50%

3. According to Al-Rawajfah and colleagues, having a central venous catheter in place in an acute care setting is one of the top five risk factors for

a. nosocomial bloodstream infection.

b. thrombophlebitis.

c. pressure ulcer development.

d. cellulitis.

4. The reported rates of catheter-related bloodstream infection (CRBSI) in home health care are

a. relatively low.

b. similar to those in acute settings.

c. relatively high.

d. excessively high.

5. For patients over 60 years old receiving IV infusions at home, Cox and colleagues reported a CRBSI rate of which of the following per 1,000 days?

a. 0.23

b. 0.49

c. 0.61

d. 0.76

6. Cox and colleagues reported that the most common drug-related complication among patients receiving IV infusions at home was

a. skin rashes.

b. blood dyscrasias.

c. nephrotoxicity.

d. hepatotoxicity.

7. The authors recommend that which of the following be reviewed during initial visits with patients receiving IV infusions at home?

a. CRBSI surveillance policies

b. the physician's orders

c. a drug-specific handout

d. the nurse's documentation

8. The nurse should be present in the home until directly observing the caregiver

a. discarding used supplies.

b. calling the agency for assistance.

c. withdrawing a blood specimen.

d. performing normal saline and heparin flushes.

9. The authors recommend that the agency have in place a systematic method for obtaining all of the necessary information

a. at the first home care visit.

b. at first contact with the referral source.

c. directly from the patient and caregiver.

d. from the patient's medical record.

10. If a patient's central line malfunctions, the agency's on-call staff must be prepared to

a. remove the central line.

b. insert a new central line.

c. restore the function of the central line.

d. insert a peripheral IV catheter.

11. Before making the decision to accept an infusion case, it is important to determine if the patient's insurance company will cover the costs of

a. two visits for the same day.

b. agency staff's driving time.

c. CRBSI surveillance methods.

d. reassigning other patients.

12. An important consideration for staff is the potential for frustration from overly long, involved teaching visits making it difficult to

a. ensure positive outcomes.

b. measure patient adherence.

c. meet weekly visit quotas.

d. address staff concerns.

13. To adequately explore the caregiver's capabilities and willingness to deliver the care the patient needs, it is recommended that agency staff meet with the caregiver

a. immediately after the patient returns to the home.

b. while the patient is still in the acute-care facility.

c. only after a thorough assessment of the patient.

d. at a location away from the home, the facility, and the agency.

14. If the patient also has heart failure, it is important to identify a formulation of the drug to be infused that is

a. more concentrated.

b. sugar-free.

c. more diluted.

d. preservative-free.

15. Before making the decision to accept an infusion case, the agency should obtain prescribing information about the drug from the

a. patient's caregiver.

b. discharge planner.

c. case manager.

d. infusion company's pharmacist.

16. When teaching the caregiver to administer total parenteral nutrition, the nurse must make sure that the caregiver

a. has a cardiac monitor.

b. bathes the patient daily.

c. has a glucometer.

d. weighs the patient daily.



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