By Niki Moore, Vice President of Product Management, One Call
Until recent years, IV therapy required inpatient admissions at either a hospital or skilled nursing facility. While there are still many indications for IV therapy using more conventional infusion techniques – such as the mechanical pump, IV Push, or Gravity – we have come a long way.
Home infusion therapy is the intravenous (IV) or subcutaneous administration of drugs or biologicals to an individual at home.1 There are a variety of reasons why an injured worker may need home infusion therapy; however, some of the most common causes include post-op complication; cellulitis; severe bacterial, viral, or fungal infection; septic arthritis; sepsis; implant or hardware infection; or hospital acquired infection.2
The elastomeric ball pump is an innovative home infusion therapy method that has shown promise over the last several years. It is portable, easily teachable, and enables injured workers to receive necessary treatment in the comfort of their own surroundings.
Injured workers who receive home infusion therapy can avoid longer hospital stays, visits to outpatient infusion clinics, or admission to skilled nursing facilities. By training someone to self-administer the treatment, you’ll also save costs on home health visits. In some instances, such as when the patient works from home, home infusion therapy even enables them to return to work quicker.
Now that you know the advantages, let’s talk about how you can put this innovative method into practice.
To properly prepare for home infusion therapy utilizing the elastomeric ball pump, an injured worker or caregiver will need the following items:
- Safe, sterile environment conducive to healing
When home infusion therapy is prescribed, it’s crucial that your first step be to partner with a home health nursing team to assess – and approve – the injured worker’s home during an initial visit.
- Prescribed drug
From there, partner with a qualified, 24/7/365 pharmacy to help expedite the shipping of necessary IV medications. Antibiotics will arrive in a Styrofoam cooler so they maintain the proper temperature. Always make sure the patient will be home to receive and refrigerate the medication in a timely manner.
- Equipment and supplies
Next, you’ll need an elastomeric ball pump, tubing, and catheter. While no device is error free, the elastomeric ball pump is very durable, reducing the risk for mechanical failure. Before using the pump, patients and caregivers should be trained in how to infuse antibiotics on the prescribed dosing schedule.
- Nursing services
Nurses are instrumental in the administration of home infusion therapy – training and educating patients and caregivers on how to perform the treatment safely and effectively. Throughout the entire process, coordination amongst patients and healthcare providers becomes essential. Key parties – such as discharge planners, health plans, pharmacies, and home health agencies – may also be involved with treatment coordination.3
Now that you’re all set up, administration can be broken down into three key steps:
- A central / peripherally inserted central catheter (PICC) line must be properly installed. A regular peripheral IV is not sufficient due to the toxic nature of the medications. In some cases, the PICC line can become obstructed. If this occurs, the injured worker, caregiver, or nurse can reach out to the pharmacist to obtain a prescription for a recombinant tissue plasminogen activator known as Activase®. The nursing agency should administer Activase as soon as possible to restart therapy.
- First dose of medication should be given under direct supervision prior to starting home therapy to help ensure no complications or reactions while at home. Although this effort does not guarantee reaction won’t occur in the future, the risk for major complications with repeat dosing is significantly lowered.
- Dressing changes should always be performed by nursing staff during their regular, periodic visits to evaluate the infusion site.
Steps for Success
Home infusion therapy is a convenient way for injured workers to receive treatment safely, effectively, and comfortably. You can greatly increase your chances for success by focusing on the following guidelines:
- Choose Reliable Partners
Make sure to establish knowledgeable, reliable partners up front – partners who will be there to encourage injured workers every step of the way – and this treatment can be a successful option for your injured workers moving forward.
- Focus on Quality of Care
Find ways to measure compliance and quality of care to help ensure injured workers heal properly. We need to create national benchmarks or guidelines to better evaluate the care our injured workers receive. Compliance measures must be developed that involve both the patient and the staffed home health agency.
- Engage the Patient
Allow and encourage injured workers to be involved. Sometimes we miss the opportunity to explain the importance of care to the patient. Home infusion therapy is an effective, but serious treatment. If not used appropriately, the outcome could be far worse than delayed recovery.
Now that you know the house rules, let’s work together as an industry to provide injured workers with this innovative treatment option – an option that puts injured workers in the driver’s seat of their own care, and improves outcomes for all involved.
1, 3 Centers for Medicare and Medicaid Services. (2023, February). Retrieved from https://www.cms.gov/files/document/hit-monitoring-report-feb-2023.pdf
2Rochester Home Infusion. (2022). Retrieved from https://www.rochesterhomeinfusion.com/services/anti-infective.html
About Niki Moore
Niki Moore joined One Call in 2023 as a vice president of product management, overseeing the durable medical equipment, home health, and complex care solutions. She joined the organization with more than 20 years of experience as a nurse leader with extensive knowledge in the management and medical file review of complex injuries.
Prior to One Call, she served as associate vice president, clinical operations for Sedgwick, where she led the telephonic case management program for more than 350 nurses across the U.S. and Guam. In her role, she was responsible for growing revenue across the existing customer base and creating growth through the implementation of a new claims management program.
Niki’s professional career also includes nearly 10 years with Publix Super Markets, Inc. where she served as a team leader of medical administration. In this role, she managed a highly skilled nursing team responsible for the company’s workers’ compensation injuries, specifically the management of complex medical and litigated claims and the development of medical care policies and procedures.
Niki started her career as a nurse case manager, spending 10 years serving various companies, including three years with WorkComp Solutions. She is a certified claims adjuster (CCA) and a certified case manager (CCM).
Niki’s impressive career is rooted in an equally strong education. She received her Master of Science in Nursing Leadership from Florida State University and her Bachelor of Science in Nursing from Polk State College.
About One Call
As a leader in the workers’ compensation industry, One Call has an unwavering commitment to getting injured workers the care they need when they need it. Leveraging more than 30 years of industry experience and innovative solutions, we are moving injured workers through their care journeys better than ever before, providing exceptional, predictive, and responsive care coordination. For more information and the latest news, visit us at onecallcm.com, LinkedIn (One Call), Facebook (@onecallcm), and Twitter (@onecallcm).
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