Name of the Procedure:

Home Infusion Therapy
Common names: Home IV Antibiotic Therapy, Home IV Antiviral Therapy, Home IV Antifungal Therapy
Technical terms: Home Infusion Therapy, Antimicrobial Infusion, S9503

Summary

Home infusion therapy involves administering medication intravenously at home rather than in a hospital setting. This allows patients to receive necessary antibiotics, antivirals, or antifungals every six hours, along with administrative services, pharmacy services, care coordination, and all required supplies and equipment. Drugs and nursing visits are coded separately.

Purpose

Home infusion therapy is used to treat severe infections that require intravenous medications, such as serious bacterial, viral, or fungal infections. The goal is to provide effective treatment while allowing patients to remain in the comfort of their own homes.

Indications

• Severe infections like sepsis, osteomyelitis, or endocarditis.
• Infections unresponsive to oral medications.
• Patients who are stable enough to receive treatment at home and do not require constant monitoring.

Preparation

• Patients may need to fast or adjust medications as advised by their healthcare provider.
• Pre-procedure diagnostic tests may include blood tests and imaging studies to assess the infection and suitability for home therapy.

Procedure Description

1. Assessment: A healthcare provider evaluates the patient to confirm they are suitable for home infusion therapy.
2. Catheter Placement: A peripherally inserted central catheter (PICC) or another type of central line is placed, if not already in situ.
3. Medication Preparation: The pharmacy prepares the antibiotic, antiviral, or antifungal medication.
4. Delivery and Setup: All necessary supplies and equipment are delivered to the patient’s home.
5. Infusion: The patient or a caregiver is instructed on how to administer the medication through the IV line every six hours.
6. Monitoring: Regular check-ins by nursing staff to ensure the therapy is working, and no complications arise.

Duration

The therapy typically takes about 30-60 minutes per infusion, administered every six hours. The total duration can range from several days to weeks, depending on the infection severity and response to treatment.

Setting

The procedure is performed in the patient’s home.

Personnel

• Pharmacists to prepare the medication.
• Nurses to educate the patient and monitor the therapy.
• Care coordinators to manage the logistics and communication.

Risks and Complications

• Common risks: mild discomfort at the infusion site, minor bleeding, or bruising.
• Rare but serious risks: catheter-related bloodstream infections, allergic reactions, thrombosis, medication errors.
• Management: Prompt detection and intervention by healthcare providers.

Benefits

• Convenience and comfort of home setting.
• Reduced need for hospital stays, lowering the risk of hospital-acquired infections.
• Continuity of care with professional support and monitoring.

Recovery

• Post-procedure care includes regular line maintenance to prevent infections.
• Recovery time varies with the infection but generally ranges from a few days to several weeks.
• Follow-up appointments as necessary to monitor infection resolution.

Alternatives

• Oral antibiotics, antivirals, or antifungals (if clinically appropriate).
• In-hospital intravenous therapy.
• Pros: Oral medications are less invasive.
• Cons: May be less effective for severe infections. In-hospital therapy may limit patient mobility and increase hospital-acquired infection risk.

Patient Experience

• The initial placement of the IV line may cause discomfort.
• Patients can expect to experience some level of normalcy as the therapy is less disruptive than hospital admission.
• Pain management might include over-the-counter pain relievers for minor discomfort.
• Comfort measures include proper positioning of the IV line and ensuring good hydration and nutrition.