Frequently asked questions about home infusion
Find out everything you need to know, from care instructions to what to do during weather emergencies.
Who pays for home infusion?
We participate with most insurance companies. All we need is your insurance information, and we'll do all the work. We'll obtain authorizations and track necessary paperwork. We have two full-time financial coordinators to assist you with insurance issues. We also have a reimbursement specialist who can help decipher confusing insurance statements and bills.
Why is hand washing so important with IV therapy?
Any time there is a penetration to the skin, there is a break in the skin's protective system, and therefore the possibility for infection exists. Since your skin's protective system was compromised with the insertion, infection may occur at the insertion site or in the bloodstream.
Organisms that ordinarily live on the skin can become harmful if they enter the body. Most infections are spread by hand contact; hands and fingers carry the most organisms. Because your IV catheter and IV site need to remain as clean as possible, everything touching them must be sterile. This is why you must wash your hands for 15-30 seconds with soap and warm water before touching your PICC line or IV site.
It's equally important to wash your hands thoroughly afterward so you do not spread any potential infection to other people or other parts of your body.
Here are some additional tips for hand washing:
When to wash your hands:
- Before and after touching intravenous tube or intravenous supplies
- Before eating, drinking, handling or serving food
- Before and after contact with sick people
- After touching sheets, bandages, towels or any patient care item
How to wash your hands:
- Use plenty of antibacterial soap.
- Scrub between fingers, palms, back of hand and wrist.
- Scrub for at least 10 seconds.
- Clean under fingernails.
- Rinse hands completely.
- Use a clean towel to gently dry your hands.
What should I do if I my IV line won’t flush?
If you attempt to flush your IV catheter and you are unable to do so, call your home care agency or Health Spectrum Pharmacy Services. Do not try to force fluid into the catheter by adding a lot of pressure to the syringe. This pressure could damage your IV line.
What should I do if I notice blood backing up in my IV line?
Flush your IV with the type and amount of fluid you have been instructed to use at the end of a medication dose. For example, if you are supposed to flush your IV with 5 ml of saline after your dose ends and then 5 ml of heparin, you should use another 5 ml of heparin.
If you have been instructed to flush with 5 ml of saline only, repeat the flushing with another 5 ml of saline. Blood that sits in your IV too long may form a clot and block your catheter.
Is it normal to have blood under the PICC dressing?
Immediately following the insertion of a PICC line, there is usually some bleeding. That is why a nurse places a white gauze dressing under the clear dressing applied on insertion of the PICC line. A nurse will change that dressing the next day or 24 hours after the insertion. Some bleeding may occur at the PICC line site if you are active or taking certain blood thinning medications. If the area of bleeding is larger than the size of a quarter or leaks out from underneath the dressing, call your home care agency so a nurse can arrange to come to your home to change the dressing.
Why do I have to take my temperature every day and why at the same time of day?
If you are on antibiotics, your temperature will tell if the antibiotics are working on your infection. Also, an early indication of an infected IV catheter is a high temperature.
You should take your temperature at the same time each day because body temperature varies throughout the day. By taking your temperature at the same time each day, you will get a more accurate measurement of a true increase in your body temperature.
What should I do if I wake up in the middle of the night with a high fever?
At the beginning of home therapy, speak to the doctor who prescribed the medicine that Health Spectrum Pharmacy Services provide to you and ask what you should do in the event of a fever. Also ask your doctor if there is a certain temperature at which he or she wants you to call.
Frequently, doctors recommend fever-reducing medications such as acetaminophen, aspirin or ibuprofen to be used for a temperature above a certain level.
My elbow feels stiff and a bit sore the day after I have a PICC inserted. Is this normal?
It is not unusual to have a bruised feeling in the bend of your arm a day or two after a PICC or midline is inserted. You may even experience some slight bruising. These are normal, but temporary, side effects of the insertion process.
They are best relieved by a mild anti-inflammatory medication, such as ibuprofen, as long as your physician approves it. You can also apply warm, moist heat to the area three or four times a day until it's better: Wet a washcloth or dishtowel with hot water, remove excess and place this towel in a 2-quart "Ziploc"-type bag. This will keep your PICC dressing from becoming wet but make it easier to reheat the towel in the microwave for a few seconds. Use caution, however, when microwaving because the towel can heat up quickly.
If these symptoms persist longer than 48 hours after insertion, notify the nurse who inserted your catheter.
My nurse used different gloves to remove my old dressing and to put on a new one. She also used waterless hand cleaner. Why?
Your nurse was doing everything right. Hands can be contaminated when removing gloves which is why it's important to use the waterless hand cleaner. By replacing the gloves for the old and new dressing change, she's ensuring your IV site remains as clean as possible by not contaminating it with anything from the old dressing. This process helps reduce the possibility of IV site infections.
Can I use the arm that I have a PICC line inserted in?
Yes. Using the arm that has an IV catheter inserted helps increase the circulation in that arm. This will not only carry the medicine you are receiving through the rest of your bloodstream, but also can keep your IV site healthier by preventing blood and other fluids from collecting in that arm.
Do not perform strenuous, repetitive arm-bending activities if your IV is inserted in the bend of your arm. This may cause the IV to work its way out. These types of activities might include shoveling snow, golf, heavy lifting and vacuuming for an extended period of time. It is recommended that you lift no more than the equivalent of a gallon of milk (about 8 pounds) at one time with the PICC line arm.
Why do they only bring out a week’s worth of medication or less even though I will be on the medication for six weeks?
Many medications are only stable for a specific number of days and therefore not all of your medicine can be sent to you at one time. Delivering weekly or more frequently allows the pharmacy to monitor your progress on the prescribed medications. The pharmacy also reviews your weekly lab results and likes to ensure you are continuing on your treatment plan with your home care agency and your doctor.
What should I do with the used syringes and IV bags?
Your nurse should instruct you on how to properly dispose of your medical waste at the beginning of your home IV therapy. The instructions will depend on what kind of medication you are receiving, whether you are using needles, and local and state laws. Please contact Health Spectrum Pharmacy Services for directions.
What is the "sharps" bucket for?
A red sharps container is given to any patient who will be disposing of specific waste that is regulated by the government or local authorities. Health Spectrum Pharmacy Services use needle-less systems for all patients, but there are occasions when needles (sharps) are required in patient care. These must be dropped in the sharps container after use. You may also dispose of the flushing syringes into the red bucket.
The disposal of other items may depend on the regulations in the area where you live. Health Spectrum Pharmacy Services track these red buckets and will collect all containers and dispose of them properly. If you have any questions as to what items belong in these containers, please contact Health Spectrum Pharmacy Services to review this process with you.
Here are some additional disposal tips:
You can help prevent injury, illness and pollution by following some simple steps when you dispose of the sharp objects and contaminated materials you use in administering health care in your home. You should place all these items below in the red bucket provided by Health Spectrum Pharmacy Services:
- IV bags and tubing
- Other sharp objects
Do not place paper products into the needle bucket. Be sure to keep containers with sharp objects out of reach of young children and animals.
We also recommend that the following be placed in securely fastened plastic bags before you put them in the garbage can with your other trash:
- Soiled bandages,
- Disposable sheets
- Medical gloves
DO NOT throw any needles in your other trash. Health Spectrum Pharmacy Services will pick up the red needle bucket for proper governmentally regulated disposal. Occasionally, your home health nurse may take the needle bucket from your home for proper disposal. For your safety, do not overfill the bucket.
Why did a Health Spectrum Pharmacy Services employee ask me about my phone, refrigerator and running water when I came home from the hospital?
We need to know you have a working phone, so that we can reach you and you can reach us at any time, for questions or more urgent concerns. We need to be certain that emergency medical services can be called from your home for anyone at any time.
Many drugs require refrigeration, so we need to know your refrigerator is clean and in good working condition. This keeps the drug safe by keeping it clean and at the correct storage temperature.
Cleanliness is very important in everyone's life, and especially while you receive your IV therapy. We need to be certain an adequate supply of fresh clean water is available for hand washing and for keeping your immediate surroundings clean. All of these questions are part of making sure your home is safe for you to receive home care.
What should I do during a snow storm or flood?
Health Spectrum Pharmacy Services will contact you with a plan in the event of a weather emergency. We will attempt to make sure your therapy is not interrupted. If you have questions or concerns about your treatment during a weather emergency call Health Spectrum Pharmacy Services.
Here are some general guidelines on what to do if your therapy is interrupted due to the weather or a natural disaster:
- Remain calm.
- Monitor TV and/or radio for weather/disaster updates.
- Follow all directions of the local/federal authorities.
Health Spectrum Pharmacy Services will make every effort to maintain contact with you and deliver your IV medication and supplies.
If you are running out of medication/supplies, call Health Spectrum Pharmacy Services at 610-402-1968.
In the event you could not reach us due to the disaster, call or go to the nearest emergency room for additional assistance.
What is the difference between a PICC line and a midline?
A midline is 3 to 8 inches long and is usually inserted in or near the bend of the arm; the tip of the catheter should end before the shoulder. This type of catheter does not require an X-ray after insertion and can be used for most antibiotics and other therapies lasting up to six weeks.
A PICC line, or peripherally inserted central catheter, is also inserted in or near the bend of the arm, but its tip goes past the shoulder and stops just outside the heart. A PICC requires a chest X-ray after insertion to make sure that the tip is in the correct place. This type of catheter can be inserted by a nurse or a doctor, either at the doctor's office or another place that has easy access to an X-ray facility.
PICCs can remain in place for a year and sometimes longer without complication. There is no maximum time they can remain inserted, as long as there are no complications with the insertion site or the catheter itself. They are used for TPN (or total parental nutrition, a very rich liquid nutrient), IV antibiotics, chemotherapy and any other therapies that may indicate the need for a PICC line.
What is the difference between a Hickman catheter and a PICC line? How do I know which is right for me?
The final decision about which type of IV line is best for you is made jointly by you and your doctor, taking into account certain factors.
Some considerations include:
- How long will the IV therapy last?
- What type of daily activities does the patient perform?
- Is the patient concerned about others seeing the catheter?
- Does the patient have any wounds, burns or rashes on the arms or chest?
These issues are important because PICCs are not recommended for lifetime IV therapy. PICCs are less invasive and less risky to insert because no sedation is required and there is no risk of lung puncture. PICCs also have a lower rate of infection because the skin temperature and bacteria count in the bend of the arm are lower than in the chest. PICCs are not recommended for people who perform repetitive arm-bending activities, because the catheter could become dislodged.
Hickman catheters are surgically inserted by a doctor into a patient's chest. Approximately 4 to 6 inches of catheter are visible outside the patient's chest. This type of catheter is more risky to have inserted because of the anesthesia and because the needle used to insert it is inserted near the upper tip of the lung. This can lead to an accidental, but rare, puncture of the lung.
Hickman catheters can remain in longer than PICCs, and are preferable for patients who may need IV therapy for an indefinite period of time. They can and do remain in for years without any complications. This type of catheter may also be chosen by someone who does not want the catheter to be visible.
What are my rights as a patient?
As an individual receiving home health care services, let it be known and understood that you have the following rights:
- To select those who provide your home care services
- To receive treatment and services within the scope of your health care plan, promptly and professionally, while being fully informed as to company policies, procedures and charges
- To receive the appropriate or prescribed service in a professional manner without discrimination relative to your age, sex, race, religion, ethnic origin, sexual preference, physical or mental handicap
- To be provided with identification by any person who enters your residence to provide home care services
- To be treated with friendliness, courtesy and respect by each and every individual representing the company who provides treatment or services for you, and be free from neglect or abuse
- To assist in the development and planning of your health care program that is designed to satisfy, as best as possible, your current needs
- To be provided with adequate information from which you can give your informed consent for the commencement of service, the continuation of service, the transfer of service to another health care provider, or the termination of service
- To express concerns or grievances or recommend modifications to your home care service without fear of discrimination or reprisal
- To request and receive complete and up-to-date information relative to your condition, treatment, alternative treatments and risks of treatment, as well as your medical records
- To refuse treatment, within the boundaries set by law, and receive professional information relative to the consequences that will or may result due to such refusal
- To have an appropriate assessment and management of pain
What are my responsibilities for my care?
You and the home care company are partners in your health care plan. To insure the finest care possible, you must understand your role in your health care program.
As a patient, you are responsible for the following:
- To read and understand all patient rights and responsibilities
- To fulfill the financial obligations as outlined in the Service Agreement
- To notify the company when encountering any problems with equipment or service
- To notify the company prior to changing your place of residence, your telephone number or health insurance coverage
- To notify the company when you will not be home at the time of a scheduled home care visit
- To involve yourself, as needed and able, in developing, carrying out and modifying your home care service plan
- To review the company’s safety information and participate in maintaining a safe environment in your home
- To request additional assistance or information on any phase of your health care plan you do not fully understand
- To notify your attending physician when you feel ill, or encounter any unusual physical or mental stress or sensations
- To inform us of your health history, including past hospitalizations, illnesses, injuries, etc.
- To provide complete and accurate information concerning your present health, medication, allergies, etc.
- To notify the company if you are to be hospitalized, or if your physician modifies or ceases your home care prescription
- To make a conscious effort to comply with all aspects of the home health care plan developed for you
Health Spectrum Pharmacy Services – Infusion Division
2024 Lehigh Street, Suite 500
Allentown, PA 18103
Hours: Monday – Friday 8 a.m.-5:30 p.m.
Saturday 9 a.m. – 3 p.m.
On-call and available all other times for home infusion needs.