PEDIATRIC INFUSION THERAPY - Msadvancedmedicine
PEDIATRICINFUSION THERAPY
Pediatric Infusion Therapy List common intravenous therapies seen in a pediatricoutpatient infusion center Describe challenges to starting a pediatric infusion center Provide updates to USP 797 regulations
ACUTEMedications IV fluids Antibiotics Steroids BloodCHRONIC Immune globulin Chemotherapy Biologics Blood factor products
VIGSolirisLumizyme
OBSTACLESMedication administrationFinancialCommunicationEmergency Preparedness
MedicationAdministration IV access Nursing experience Chemoport AnxietyOral medications
FINANCIAL Inventory Pharmacy vs Medical benefit Prior authorizations Reconciliation
Communication Physician Parent/caregiver Patient
EmergencyPreparedness PALS Crash cart AED Broselow tape Documentation
PHARMACEUTICAL COMPOUNDING“Compounding” – the act of combining or altering ingredients tocreate medicines to meet the unique medical needs of individualpatients“Sterile compounding” – combining, admixing, diluting, pooling,reconstituting, repackaging, or otherwise altering a drug or bulkdrug substance to create a sterile medication
United StatesPharmacopeialConvention(USP)USP 795 PharmaceuticalCompounding – Nonsterile Preparations USP 797 PharmaceuticalCompounding – Sterile Preparations USP 800 Hazardous Drugs –Handling in Healthcare Settings USP 825 Radiopharmaceuticals –Preparation, Compounding, Dispensing,and Repackaging
RISK LEVELSUSP 797 UPDATES Eliminated low-, medium-, and high-risk Category 1 vs Category 2 Category 1 – CSPs prepared in a segregatedcompounding area Category 2 – CSPs prepared in a clean room suiteImmediate Use
Category 2 Compounded SterileProducts (CSPs) CSPs prepared in a clean room suite Ante room and buffer room containing a laminarairflow system (hood) or restricted-accessbarrier system (glovebox) 4 days at room temp, 10 days refrigerated, 45days frozen Regulations for garbing, cleaning, airpressure/filtration/exchanges, surface and airsampling
Category 1 CompoundedSterile Products CSPs prepared in asegregated compoundingarea. Contains a hood,glove box or isolator. Musthave visible perimeter,away from windows, doorsto outside, or high-trafficareas. 12 hours at room temp and24 hours refrigerated Cleaning, sampling, garbingrequirements still apply
Immediate useCSPs Prepared outside of asterile environment No more than 3different sterileproducts Intended for directadministration to aspecific patient within4 hours
USP 797 UPDATES BUD for single-dose vial is now 12hours when punctured in ISO 5environment Master formulation record Compounding record Provisions for administration andpreparation per approved labeling
USP 797 UPDATES Surface sampling has been changedfrom “periodically” to “monthly” Addition of a sporicidal agent tocleaning and disinfecting regimensrequired monthly Same garbing requirementsregardless of Category 1 or 2 CSP Allergenic extracts
USP 797 : Allergenic Extracts PERSONNEL QUALIFICATIONS Designated person to train,evaluate, supervise Prior to compounding PERSONNEL HYGIENE AND GARBING Hand hygiene and garbingprocedures according to facilitySOPs Complete training about principlesand skills for sterile compounding Low linting garment enclosed atneck and tight at wrists Complete gloved fingertip sampling Face mask Competency testing (includingwritten/electronic) Hair covers Sterile powder-free gloves Must use sterile 70% IPA throughoutthe compounding processAnnual evaluation – glovedfingertip, media fill test
USP 797 : Allergenic Extracts Facilities ISO Class 5 primary engineering control (PEC) Dedicated allergenic extracts compounding area (AECA) walls, floors, fixtures, shelving, counters, cabinets must be cleanable Compounding surface must allow for easy cleaning and disinfectingRestrictions on location (away from traffic, windows, food, restrooms, etc)Cleaning and disinfecting Daily cleaning with sterile 70% IPA Monthly cleaning – walls, doors, ceilings Vial stoppers
USP 797 : Allergenic Extracts BUD – no later than expiration date on each extract or diluent, and must notexceed 1 year from the date the prescription set is mixed or diluted Labeling Documentation SOPs Personnel training records, competency assessments, qualification records,corrective actions Certification of PECs if used Temperature logs for refrigerators Compounding records
Pediatric Infusion Therapy List common intravenous therapies seen in a pediatric outpatient infusion center De
Infusion NursingJournal of The Journal of Infusion Nursing is a member benefit of the Infusion Nurses Society. INS is a professional association dedicated to enhancing infusion prac-tices that will improve patient outcomes. Through its many member benefits, INS offers access to the latest infusion research, technology, and education. For
What are the RCN standards for infusion therapy? Evidence based guidelines for all infusion therapy Produced by the RCN Published in Dec 2016 - 4th edition Well renowned and referred to globally Updated to reflect current needs 12 areas of practice identified New section (10) included re OPAT and service provision
Communication Skills Learning Tools for the Pediatric Clerkship 37 Pediatric History Taking Approach to the Pediatric Patient 38-39 Explanation of Pediatric H&Ps/Pediatric Database 40-43 Example H&Ps (older child and infant) 44-52 Pediatric Physical Examination Benchmarks for Pediatric Physical Examination 53 54-65
To resume an infusion: 1 From the toolbar, select CONTINUE. TO STOP/RESUME AN INFUSION To stop an infusion using the STOP hard key: 1 At the bottom of the pump, press STOP. The infusion pauses. To resume an infusion: 1 From the toolbar, select CONTINUE. 2 From the toolbar of the Attentio
Roboz Surgical Instrument Co Subject: Vascular Access Keywords: infusion instruments, infusion tubing, polyethylene tubing, introduction needle, infusion canula, fastbreak cannulas, splitable introducer cannula, heart holding forceps, micro injection needles, advance infusion pump, advance infusion table,
IV INFUSION FAQ SHEET . 20. 14. 1. A Hydrating infusion is defined as an infusion of fluid and electrolytes (eg, normal salin e, D5-1/2 normal saline 30mEq KCL/liter). Administration of electrolytes for a therapeutic purpose is billed as a hydrating infusion. 2. Do we charge for IV fluids (IVF) used behind blood, heparin or nitroglycerin? a.
infusion pump is the preferred and safer way of delivering this type of infusion. Community IV services may use a control flow administration set. When the infusion bag is empty and disconnected from the patient the infusion giving set tubing will contain a residual quan
The level of management responsible for developing strategic goals is: A. line B. supervisor C. functional D. senior . D. other organisations that do business with the 14 Where a stakeholder is identified as having high interest and low power, an organisation should: keep them satisfied monitor their interests and power C. manage them closely keep them informed 15. Highfield Aeet 12 .
