PREPARATION AND INSTRUCTION NEEDED
FOR CARE AT HOME
Patients are increasingly getting much of their care at home.
Yet if a patient is to be cared for appropriately at home,
families and caregivers need clear and adequate instructions
from health care professionals to be sure that such care is
safe and effective. The following story shows why.
A three-year-old cancer patient who couldn't eat was discharged
from the hospital with a feeding (nasogastric) tube in place
from her nose to her stomach. Her mother was taught to unclog
the feeding tube by drawing ginger ale into a syringe and
injecting it through the tube.
When the child was later readmitted for routine chemotherapy,
she developed an infection and had to receive antibiotics
intravenously (IV) through a tube inserted into the child's
veins - a peripherally inserted central catheter (PICC). The
antibiotic IV had to continue at home, even after the child
was discharged, and follow-up was arranged with the hospital's
home care department.
However, soon after the child went home, her antibiotic IV
(PICC) clogged. The patient's mother mistakenly assumed that
the ginger ale method of unclogging the nasogastric tube would
also work for unclogging the antibiotic IV line. Luckily,
the home care nurse arrived just in time to prevent the terrible
tragedy that certainly would have resulted had the mother
injected ginger ale into the child's veins.
No patient should be sent home on IV therapy unless the patient
and home caregivers have gotten clear and complete instructions
from a health care professional about what to do if complications,
including clogged lines, arise. Patients and their caregivers
can be an important safety factor in their own medication
use by insisting on clear and complete names of medications,
dosages, explanations of what the medication is intended to
do, and full instructions about what to do if complications
or emergencies arise. Keep and share with your health care
provider a complete and up-to-date list of the medications
you are taking. And, always repeat related instructions to
the health care provider to make sure you've understood correctly.
Institute for Safe Medication Practices