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HOME INFUSION STANDARDS

DRESS CODE
 
  • An ID badge should be worn at all times in the home.

    • If you misplace your HHC badge, wear your hospital/work badge until your HHC badge can be found/replaced.

  • All solid-colored scrubs are acceptable; please avoid patterned/graphic scrub designs.

  • Jeans or scrub pants paired with an HHC t-shirt or sweatshirt is also acceptable.

  • Refrain from expressing non-clinical related opinions or discussing polarizing topics (religion, politics, etc.).

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HOME ETIQUETTE
 

  • Do not speak negatively about the patient’s pharmacy or complain about pharmacy supplies.

    • We partner with and work for the pharmacies dispensing medications & supplies. The patient should see a united, joint effort between our agency and the pharmacy.

  • Politely decline offers for food or other conveniences.

  • Avoid smells. Do not wear perfumes, lotions or other strong smelling cosmetics.

    • ​Do not enter a home smelling of cigarette smoke. Consider keeping a spare change of scrubs as needed in your vehicle.

  • You CANNOT leave a patients home while they are infusing to go get food or for any other reason.

    • For long infusions, it is appropriate to bring a snack or lunch. Bring ready-to-eat items.



PROFESSIONAL COMMUNICATION
 

  • Always speak professionally and respectfully. Even when you are comfortable with a patient/family, you are a professional providing a service.

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  • Avoid indicating to the patient that you are “new” to home care, or you have “never” seen or done something. While this may be true and make you feel better, it causes unnecessary fear for the patient.

    • When you are unfamiliar with a supply, pump, or clinical process while in the home, kindly excuse yourself and call us.

    • Explain that you want to “double-check with a supervisor” or “get clarification” on something.

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  • DO NOT call the pharmacy unless directed by our agency. Always call/text us first, and allow a few minutes for us to address your concern.
     


ENTERING THE HOME
 

  • ALWAYS INTRODUCE yourself. “Hi, my name is Sarah, with Helms Home Care nursing.”

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  • WASH YOUR HANDS. Ask the patient for a sink with soap and water.

    • If the patient does not have soap or water, verbally explain that you will use hand sanitizer in lieu of soap and water.

    • Do not use hand sanitizer in lieu of hand washing without explaining this to the patient. It is very important that the patient see and understand your hand sanitizing etiquette. Lack of hand washing is the #1 complaint in home care.

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CALLING YOUR PATIENTS
 

  • Always confirm a scheduled visit. For IVIG, biologics, and other RN infusions, make sure to confirm that the patient has received their shipment/supplies/medication from the pharmacy.

    • For visits scheduled 2+ weeks prior, call/text 2-3 days before the visit

      • Contact our offices if the patient does not reply/confirm

    • For visits scheduled the previous week, call/text the day prior

      • Contact our offices if the patient does not reply/confirm within 24 hours

    • For visits scheduled same day or day prior, call/text on the way as a courtesy, confirmation is not needed.

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  • If you are running late or need to reschedule an appointment, call your patient as soon as possible.

    • Please keep us in the loop, especially if re-scheduling becomes a conflict and you are unable to complete a visit, but generally you should communicate and schedule directly with your patients to be most efficient with everyone’s time.

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  • Your car kit contains standard business cards so you can provide your patients with your contact information (for scheduling purposes only).

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  • If a patient calls you directly with medical related questions, please direct them to our 24/7 on-call line (704-802-9655 – on the front of the HHC pamphlet).

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IV ACCESS
 

  • PICC/Central/Port dressings must be changed every 7 days. If we can’t go on Day 7, strive for Day 6, avoid Day 8.

    • Weekly PICC line dressing changes and lab draws should be scheduled together each week, generally on Sunday or Monday – or the day specified on the order.

    • PICC line dressing supplies vary by pharmacy and may look different from patient to patient. If supplies are not present (such as a missing bio-patch), or running low, please notify us asap.

    • PICC line dressing changes should include changing of end caps, bio-patch, and stat-lock/securement device.

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  • A peripheral IV access is good for 72 hours, after which we need to either: (1) remove the IV, (2) change out the IV, or (3) document that the IV is patent, flushing, and void of redness, pain, or swelling.

    • When attempting to start a peripheral IV or access a port, call our office when access is not achieved after (2) attempts. Depending on the pharmacy, 2 or 3 attempts is the max allowed.

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  • S.A.S.H. method – stands for Saline, Administer Meds, Saline, Heparin

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OBSERVE, REVIEW, VERIFY
 

  • OBSERVE & REVIEW SUPPLIES before starting an infusion.

    • It is important for you to verify (with your hands and eyes) that all needed supplies and medications are available, appropriate, and in usable condition.

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  • VERIFY THE ORDER/DOSE/MEDICATION.

    • Always verify you are providing the appropriate dose per the MD order, that the meds are usable (not expired; not cloudy/tainted; and at the appropriate temperature).

    • Your documentation should always include the name of the medication along with the dose, route, expiration, lot number(s), and rate/method in which a medication is administered.

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  • DO NOT leave the narrative section of the visit note blank. If there are no issue with the visits, it can be as simple as: “Dressing change and lab draw completed per policy. PT educated on care and has no concerns at this time.”

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ASEPTIC & STERILE TECHNIQUE
 

  • Don gloves as often as possible during home visits.

    • Even when gloves may not be required or necessary, they provide an added appearance of professionalism that keeps patient’s minds at ease.

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  • Sterile gloves for sterile procedures (dressing changing, port access, etc.).

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  • Clean gloves for aseptic procedures.

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  • Gloves are provided in your car kit.

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HELP US HELP YOU
 

  • For any therapy, medication or clinical process that you are unfamiliar with, please alert our staff, if possible, prior to visiting the patient.

    • Our clinical team can walk you through various clinical processes, pumps, supplies, and medications prior to the visit to ensure your are knowledgeable and competent.

    • If you are at a patient’s home and still unfamiliar or unsure, CALL US! Let the patient know you are “getting clarification” and get us on the phone to help. Do not alarm the patient. Do not guess, assume, or wing-it.
       

  • If you are scheduled to see an IVIG patient, you must complete training prior to your first IVIG infusion visit.

    • Please alert the Care Coordinator asap so training can be scheduled.

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