Subcutaneous immunoglobulin replacement therapy: ensuring success.

Subcutaneous immunoglobulin (SCIg) infusions are an option for patients requiring immunoglobulin therapy. Nurses are uniquely positioned to advocate for patients and to teach them how to successfully manage their infusions. The purpose of this review is to describe SCIg therapy and to provide teaching instructions as well as creative tips to ensure treatment success.

Subcutaneous immunoglobulin therapy home.

Subcutaneous immunoglobulin (SClg) replacement therapy is a new clinical service development in adult respiratory care undertaken at the Royal Brompton and Harefield Foundation Trust. SCIg therapy reduces appropriate patients' susceptibility to recurrent acute and chronic respiratory infections. Patients with specific chronic respiratory conditions and antibody deficiency can be treated with SCIg therapy at home, rather than with intravenous immunoglobulin (IVIg) therapy in hospital. Using a personalised teaching programme and managing the daily demands of the clinical service promotes greater concordance with treatment. With over 34% of our immunoglobulin therapy patients now on SCIg replacement therapy, this treatment innovation has brought about high levels of patient satisfaction and cost savings to trust budgets.

[Educational program for doctors and nurses taking care for primary immunodeficiency patients treated with subcutaneous immunoglobulins]. / Propozycja programu edukacyjnego dla lekarzy i pielegniarek zajmujacych sie terapia substytucyjna podskórnymi preparatami immunoglobulin u pacjentów z pierwotnymi niedoborami odpornosci.

Primary immunodeficiency diseases (PIDs) are presenting the most common in childhood. PID are genetically determined disorders of the immune system resulting in greatly enhanced susceptibility to infectious disease. Therapy in these group of patients preventing infectious diseases is immunoglobulin (Ig) replacement therapy. Nowadays the quality of life is very important issue which doctors should consider treating their patients. The subcutaneous immunoglobulins appears to be the best solution for them. Treating patients with subcutaneous Ig require good educational programme not only for patients but also for doctors and nurses. We would like to provide practical guidelines for identifying patients who should be referred for assessment of possible immunodeficiency and give some practical instructions how to start and follow-up subcutaneous therapy in all centers of immunology in Poland who are engaged in this kind of treatment.

Sorovacinação antirrábica: aspectos epidemiológicos e implicações para a assistência de enfermagem / Anti-rabies serovaccination: epidemiological aspects and implications for nursing care

This study was developed with the purpose to search for relevant knowledge concerning nursing care for individuals exposed to the rabies virus and submitted to post-exposure anti-rabies serovaccination. The authors aimed at evaluating the epidemiological aspects of accidents involving household and wild animals occurring in 2007 and patients assisted at a reference hospital located in the mid-southern region of São Paulo State. They also aimed at identifying the relevance of nurses' actions by describing aspects of care provision. The method adopted was exploratory, retrospective and descriptive of the epidemiological aspects of the accidents and of the care provided to these patients by referring to information in their medical charts. Fifty-one charts of patients aged 17 to 81 years, considered to be at risk and with indication for post-exposure prophylaxis against human rabies were evaluated. It was found that nursing care provision to these patients presents low complexity although it requires properly trained professionals. It was possible to identify the relevance of nurses' actions in care provision and procedures related to anti-rabies prophylaxis; however, consistent information concerning nursing care was not observed.

Este estudo foi desenvolvido com a finalidade de buscar conhecimentos relevantes para a assistência de enfermagem a indivíduos expostos ao vírus da raiva submetidos à sorovacinação antirrábica pós-exposição. Os autores se propuseram a realizar esta pesquisa com os objetivos de verificar aspectos epidemiológicos dos acidentes por animais domésticos e silvestres ocorridos no ano de 2007 que foram atendidos em um hospital de referência localizado na região centro-sul do Estado de São Paulo, e identificar a relevância das ações do enfermeiro, descrevendo aspectos do cuidado. O método adotado foi exploratório, retrospectivo e descritivo dos aspectos epidemiológicos dos acidentes e da assistência a esses indivíduos por meio de informações constantes nos prontuários dos pacientes. Foram avaliados 51 prontuários de pacientes com idades entre 17 e 81 anos, considerados em situação de risco, com indicação de profilaxia pós-exposição contra raiva humana. Constatou-se que a assistência de enfermagem a esses pacientes é de baixa complexidade, embora requeira profissionais com preparo adequado para esse atendimento. Foi possível identificar a relevância das ações do enfermeiro na assistência e nos procedimentos relacionados aos cuidados que devem ser seguidos na profilaxia antirrábica, porém não foram encontradas informações consistentes sobre a assistência de enfermagem.

Training and support to enable home immunoglobulin therapy.

This article describes the development of an immunoglobulin home therapy and support service. The service provides patients with the education and training that they need to be able to undertake immunoglobulin therapy at home. To facilitate this the trust's competency-based enhanced practice framework was adapted. Evaluation through clinical audit and a patient satisfaction survey has yielded positive results, indicating that the enhanced practice framework provides a robust and effective approach to patient education.

Care of patients undergoing immunoglobulin therapy.

Immunoglobulin infusion is becoming more widely used as treatment for a variety of conditions. This article describes the background and uses of immunoglobulin therapy and the nursing care of patients undergoing this treatment.

[Posture taken by members of the nursing staff during blood collection, intravenous drug administration and serotherapy]. / Postura corporal adotada pelos membros da equipe de enfermagem durante procedimentos de colheita de sangue, administração de medicação endovenosa e soroterapia.

The members of the Nursing Team are submitted, many times, to posture attacks either due to the own requirement of the action or the utilization of improper corporeal posture during its execution. The present study aims at inquiring the type, length, frequency and posture changes adopted by the members of the Nursing Team during the execution of blood collection techniques, administering of intravenous medication and serotherapy. Through direct observation were recorded 10 activities corresponding to each one of the mentioned techniques, realized in attendance of patients from a University Hospital internment unit. The results evidenced that blood collection activity was 50, 35% effectuated in the inclined standing position, followed by the standing straight position, 49, 64%. Intravenous medication administering was executed with frequent adoption of the standing straight posture, 51, 09% (in special with the arm in frontal expansion), 45, 74% in the inclined standing position and 3, 15% seated. Serotherapy technique was executed with predominant adoption of standing position (86, 88%) in special with the arms in frontal expansion and 13, 11% in the inclined standing position. The unnecessary adoption, many times, of inclined standing posture indicates that Nursing personnel have been making possible the happening of spinal column attacks mainly due to the bad utilization of corporeal mechanic. The authors suggest more attention to these aspects, mainly at Nursing courses.