Name of the Procedure:

Home Infusion Therapy for PICC Line Insertion
Common Name: Home Infusion Therapy
Technical Term: Peripherally Inserted Central Venous Catheter (PICC) Insertion (HCPCS Code S5520)

Summary

Home infusion therapy involves the use of a peripherally inserted central venous catheter (PICC) line to deliver medications, nutrients, or other fluids directly into the bloodstream. This procedure includes all necessary supplies, including the catheter, and is typically performed at home under professional supervision.

Purpose

The primary goal is to provide long-term intravenous (IV) access for patients requiring extended therapy such as antibiotics, chemotherapy, or nutrition. It is particularly beneficial for patients with chronic conditions, enabling them to receive treatment in the comfort of their own homes.

Indications

• Chronic infections requiring long-term antibiotic therapy
• Cancer patients needing chemotherapy
• Patients requiring long-term IV nutrition or hydration
• Those needing frequent blood draws
• When peripheral IV access is not suitable or reliable

Preparation

• Patients might be instructed to fast for a few hours prior to the procedure.
• Any current medications should be discussed with the healthcare provider.
• Blood tests or imaging studies may be required to assess vein conditions.

Procedure Description

1. The healthcare provider will clean and sterilize the insertion site, usually in the upper arm.
2. Local anesthesia is applied to numb the area.
3. Using ultrasound guidance, a small needle is inserted into a suitable vein.
4. A guidewire is then introduced through the needle, followed by the catheter which is threaded through the vein up to a central vein near the heart.
5. The catheter is secured in place, and a sterile dressing is applied.
6. The provider will ensure the catheter is working properly by flushing it with saline.

Duration

The entire procedure typically takes between 30 to 60 minutes.

Setting

This procedure is performed in the patient's home, under the supervision of a trained home healthcare nurse or a specially trained technician.

Personnel

• Registered Nurse (RN)
• Physician Assistant (PA) or Nurse Practitioner (NP) for the initial consultation
• Home health aides may assist with post-procedure care

Risks and Complications

• Infection at the insertion site
• Blood clots (thrombosis)
• Catheter malfunction or migration
• Minor bleeding or bruising
• Rarely, air embolism or injury to nearby structures

Benefits

• Convenient and comfortable, as it is performed at home
• Minimizes hospital visits or stays
• Allows for consistent intravenous therapy
• Reduces the risk of frequent needle sticks

Recovery

• Follow care instructions provided by the healthcare team, including keeping the site clean and dry.
• Patients can generally resume normal activities shortly after the procedure but should avoid heavy lifting or strenuous exercise.
• Regular follow-up appointments will be scheduled to monitor the catheter and overall health.

Alternatives

• Standard IV Therapy (requires frequent clinic visits)
• Subcutaneous infusion (suitable for certain medications)

• Oral medications (if feasible)

  Pros of Alternatives: May be less invasive and have fewer complications. Cons of Alternatives: Less reliable for long-term therapy; requires frequent clinical visits; may not be suitable for all medications.

Patient Experience

During the procedure, patients might feel some pressure or slight discomfort at the insertion site. After the procedure, most patients experience minimal pain, managed by over-the-counter pain relievers like acetaminophen or ibuprofen. It's important for patients to monitor the insertion site for signs of infection and report any concerns to their healthcare provider.