Foundation for establishing a home i.v. program.

The nature of the health care industry is changing as increasingly greater numbers of patients are treated in the home setting. When setting up its own home IV program, a home care agency must address three areas involving nursing care: licensure requirements, hiring criteria, and patient selection.

Domiciliary chemotherapy for malignant disease.

A prospective trial was carried out comparing hospital-based chemotherapy with domiciliary chemotherapy. Fifteen women received cisplatin combination regimens to treat gynecologic cancers. The first course was given in a hospital inpatient setting, and subsequent courses were given to each patient in her domicile. Seventy-four courses were given at home under the direction of a nurse trained to administer chemotherapy. There were no extravasations or anaphylactic reactions. In the period immediately following the at-home administration, no patient required hospitalization for dehydration or for adverse reactions to the chemotherapy. Written interviews with patients and family members were conducted after completion of the course of treatment. No patient wanted to return to the hospital environment. All patients preferred to be treated at home, usually because of the increased privacy, convenience, and lessened anxiety.