Clinical evaluation of elastomeric hydrogel peripheral catheters during home infusion therapy.

The use of elastomeric hydrogel (Aquavene, Menlo Care, Menlo Park, Calif.) peripheral catheters in home infusion therapy was prospectively evaluated. Elastomeric hydrogel catheter composition differs from that of conventional peripheral catheters made of Teflon or silicone in that it softens upon insertion and expands two gauge sizes within 30 minutes of insertion. Fifty-four test catheters were successfully placed in 44 home infusion therapy patients, for a total dwell time of 290 days. Average dwell time was 5.37 days, with a range of 1 to 20 days. The extension of dwell time beyond the accepted standard of 72 hours was not associated with an increased incidence of phlebitis when compared to the incidence of phlebitis reported in the scientific literature. The ability to extend peripheral catheter dwell time without increasing the incidence of catheter-related complications may have major clinical and economic advantages for the payors, providers, and consumers of home infusion therapy.

Initiation of a home hemotherapy program using a primary nursing model.

A home hemotherapy pilot study was implemented based on a primary nursing model. Seventy-one patients received a total of 248 units of red blood cells and 104 units of platelets during 137 home transfusions. In no case did a clinical change in patient status require the interruption of the transfusion. Total nursing time for the pretransfusion, transfusion, and posttransfusion follow-up visits for each patient averaged 4.36 hours, while another 4.45 hours accounted for nurse travel to and from the home and the blood bank. Home hemotherapy is a viable option for selected homebound patients. Program success is dependent on staff education, strict clinical guidelines, and an acknowledgment of the time required to provide quality patient care.