CHAPTER 6 Periodic deliveries (usually weekly) to the patient’s home are neces-


sary. The patient’s home must be clean and have a safe place to store all equipment away from children and pets. The home should have electric- ity, running water, and a working telephone. Ideally, a designated refrig- erator for PN formulas and injectable medications should be available.7,11 If this is not possible, patients must designate a shelf in their refrigerator that will only be used for PN supplies. Home nutrition support providers may direct patients to the emergency department if they lose power for a prolonged period and therefore cannot maintain PN at the appropriate storage temperature.


Patient Education


Education of the patient or caregiver should begin as soon as possible in the hospital and continue in the home. Education should be provided by qualified health care professionals specifically trained or credentialed in HPN support. The trainer may use various tools to aid in the education process, including videos, checklists, mannequins, training vests, and illustrations. Interactive educational interventions have been shown to reduce catheter-related blood stream infections and reactive depression, and they improve the ability of patients to problem-solve with health care professionals.25


Patients and caregivers should be provided with written


copies of instructional materials or a manual that outlines all HPN proce- dures in a clear and concise manner.


EXPERT INSIGHT


Training in all PN infusion procedures may take several days to several weeks to establish patient or caregiver competence and independence in all procedures.


Education Procedures


For the safe administration of HPN, patients must be taught several pro- cedures, including the following26


:


ƒ aseptic technique ƒ CVAD care ƒ PN administration procedures, such as hookup and disconnection ƒ infusion pump operation


98


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132  |  Page 133  |  Page 134  |  Page 135  |  Page 136  |  Page 137  |  Page 138  |  Page 139  |  Page 140  |  Page 141  |  Page 142  |  Page 143  |  Page 144  |  Page 145  |  Page 146  |  Page 147  |  Page 148  |  Page 149