Infusion Services
- Antibiotic / Antimicrobial Therapy
- Total Parenteral Nutrition (TPN)
- Cardiovascular / Inotropics
- Hydration
- Pain Management
- Steroid Management
- Hemophilia/Factor Products
- Chemotherapy
- Anti-coagulants
- Catheter Maintenance
- Iron Chelation (Desferal)
- Enteral Nutrition
Antibiotic / Antimicrobial Therapy
- Typically a short-term therapy (can be administered from 1 day - 6 or more weeks)
- Utilized to treat infections unresponsive to oral antibiotics
- Recommended short-term line placement for therapies lasting longer than 1 week in duration.
- Administration method may vary from IV Push to Gravity to Pump.
- Labs may be ordered and are based on drug as well as length of therapy.
- First Dosing in the home may be possible. Please consult a Chartwell pharmacist.
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Indications/Candidates for Antibiotics
- Osteomyelitis
- Bacterial Endocarditis
- Wound Infections
- Cystic Fibrosis
- Bacteremia
- Septic Arthritis
- Cellulitis
- Fungal Infections
- Urinary Tract Infections
- Respiratory Tract Infections
Total Parenteral Nutrition (TPN)
- Can be a short-term or long-term therapy depending on diagnosis.
- Utilized to provide complete nutrition when oral means are not possible due to disease process.
- Patients must have long-term venous access device in place.
- Administered utilizing pump.
- Labs ordered by physician based on clinical response. Lab frequency typically decreases as patient becomes less acute.
- First dosing in the home not desirable due to frequent laboratory monitoring required with initiation of TPN.
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Indications/Candidates for TPN
- Inflammatory Bowel Disease
- Massive Bowel Resection
- Intestinal Obstruction
- Short Bowel Syndrome
- Motility Disorders
- Crohn's Disease
- Ulcerative Colitis
- Enteritis
- Mesenteric Infarction
- Hirschprung's Disease
- Malabsorption Disorders
Cardiovascular / Inotropics
- Typically a chronic therapy. Infusion may be continuous, daily or even every other day dependent on patient diagnosis/condition.
- Utilized to increase cardiac output and or blood pressure. Also increases renal perfusion and urine output.
- Patients must have long-term venous access device in place.
- Administered utilizing pump.
- Labs ordered by physician based on clinical condition.
- No first dosing in the home.
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Indications/Candidates
- Congestive Heart Failure
- Hypotension
Hydration
- Typically an acute therapy. Infusion may be continuous, daily or even weekly dependant on patients clinical status.
- Utilized to provide fluids for re-hydration.
- Venous access device dependant upon frequency and duration of infusion. Durations of longer than 1 week should have short-term venous access device placed.
- Administered via controlled gravity device or by pump.
- Labs ordered by physician based on clinical condition.
- Typically can be first dosed in the home depending upon presence of additives.
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Indications/Candidates
- Dehydration
- Hyperemesis
Pain Management
- Typically a chronic therapy for patients of which oral pain medications are no longer effective.
- Prescribed for patients with short-term as well as long-term pain. May be administered IV or subcutaneously.
- Venous access device dependant upon frequency and duration of infusion. Durations of longer than 1 week should have short-term venous access device placed. Subcutaneous infusions do not require venous access devices.
- Administered via pump.
- Labs not typically ordered.
- First Dosing in the home may be possible. Please consult a Chartwell pharmacist.
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Indications/Candidates
- Chronic /Acute Pain
Immune Globulin
- Typically a chronic therapy prescribed for patients that have a deficiency of their immune system. Immune globulin provides immediate antibody levels lasting approximately 3-4 weeks.
- Infusions are typically scheduled every 4 weeks.
- Long-term venous access devices are not necessary unless patients have poor venous access but are beneficial to the patient to avoid routine venipunctures.
- Administered by titration utilizing a pump.
- Labs may be ordered at the discretion of the physician.
- First dosing in the home is not recommended due to the potential for anaphylactic reactions.
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Indications/Candidates
- Immunodeficiency
Steroid Management
- Typically a chronic therapy prescribed to suppress inflammation.
- Infusions are typically scheduled every 4 weeks dependant on patients clinical condition.
- Venous access device dependant upon frequency and duration of infusion. Durations of longer than 1 week should have short-term venous access device placed.
- Administered via controlled gravity device.
- Labs not typically ordered.
- Typically can be first dosed in the home.
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Indications/Candidates
- Multiple Sclerosis Exacerbation
- Exacerbation of Irritable Bowel Disorders
Hemophilia/Factor Products
- A chronic therapy prescribed to prevent and or to control bleeding.
- Prescribed for patients with factor/clotting deficiencies.
- Venous access device dependant upon frequency of infusions. Most patients utilize butterfly needles infuse.
- Administered via IV Push.
- Labs not typically ordered.
- Typically not first dosed in the home.
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Indications/Candidates
- Hemophilia
- Von Willebrands Disease
Chemotherapy
- Prescribed to treat cancer. Typically given in multiple drug combinations.
- Infusions may be continuous over a period of one week, or infused monthly over a specified period of time dependent on patient diagnosis, condition and therapy protocol.
- Long-term venous access device is desirable.
- Can be administered via gravity, IV push, or via infusion pump. Some chemo agents can be administered IM or SQ.
- Labs can be ordered several days per week, weekly or monthly depending on patients clinical condition and response to therapy.
- Typically not first dosed in the home. Please consult a Chartwell Pharmacist.
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Indications/Candidates
- Cancer-related diagnoses
Anti-coagulants
- Prescribed to treat and or prevent coagulation/clotting disorders.
- Infusions may be continuous or intermittent based on patients clinical condition
- Venous access device dependant upon frequency and duration of infusion. Durations of longer than 1 week should have short-term venous access device placed.
- Administered via IV push, by infusion pump or by subcutaneous injection.
- Labs are typically ordered frequently depending on method of administration to monitor patients response to therapy.
- Typically not first dosed in the home. Please consult a Chartwell Pharmacist.
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Indications/Candidates
- Deep Vein Thrombosis
- Pulmonary Embolism
- Coagulation Disorders
Catheter Maintenance
- Can be long-term or short-term based on diagnosis.
- Prescribed for patients with short-term or long-term venous access devices that are currently not receiving medications daily but may need venous access in the near future.
- Supplies such as dressing change kits and flushes are provided. Patients are educated regarding how to care for their catheter.
- Labs may be ordered at the discretion of the physician.
- Initiating therapy in the home is acceptable.
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Indications/Candidates
- Patients with long-term or short-term Central Venous Access Devices
Iron Chelation (Desferal)
- Prescribed to treat acute iron intoxication/overload
- Infusions are typically continuous over a period of 4-12 hours.
- Infusion may be administered IV or subcutaneously.
- Venous access device dependant upon frequency and duration of infusion. Durations of longer than 1 week should have short-term venous access device placed. Subcutaneous infusions do not require venous access device.
- Administered via infusion pump.
- Labs may be ordered at the discretion of the physician.
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Indications/Candidates
- Iron Overload
- Hemochromatosis
Enteral Nutrition
- Prescribed for patients who are unable to maintain nutritional needs eating a typical diet.
- Can be a sort term or long term therapy based on patients clinical condition.
- May be taken orally or infused via a gastric tube.
- Can be administered via bolus, gravity or infusion pump.
- Labs typically not ordered
- Initiating therapy in the home is acceptable.
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Indications/Candidates
- Dysphagia
- Head and Neck Cancer
- Aspiration Pneumonia
- CVA/Stroke