Nursing homes can apply to have the ability to administer intravenous fluids and antibiotics. More nursing homes have received approval to give IV fluids and medications to their residents.<\/p>\n\n\n\n
The same nursing homes have training in the proper care of IV sites and administration of these fluids.<\/p>\n\n\n\n
Intravenous fluids (IV) can be given to residents for signs and symptoms of dehydration, various types of infections, and many other reasons. Many types of IV antibiotics can be administered in the nursing home, including heavy-duty antibiotics such as ertapenem, linezolid, and more. <\/p>\n\n\n\n
Most nursing homes do administer IV fluids and antibiotics. They have become mini step-down units for the hospitals in providing care to the residents. Therefore they need the ability to deliver the medications the patients require. <\/strong><\/p>\n\n\n\n\n
The good news is, the nursing home pharmacy is the one that reconstitutes and mixes the antibiotics in the IV fluid. Having the pharmacy mix the medications leaves less chance for error when preparing the medicines.\u00a0<\/p>\n\n\n\n
The\nnurses are in charge of caring for the IV site and administering the\nmedications. They will be the ones changing your PICC line dressing site,\nflushing the lines, and making sure the IV site looks healthy.<\/p>\n\n\n\n
The findings and studies have shown that nursing home patients should be treated in the nursing home if the nursing staff has adequate training and access to hydration and antibiotics.\u00a0<\/p>\n\n\n\n
When a nursing home resident needs IV treatment, and the facility isn’t able to administer it, the patient will be sent to the hospital. They will then receive intravenous fluids or antibiotics during their hospital stay.\u00a0<\/p>\n\n\n\n
The\nnursing home may lack the skills or capacity to give this sort of treatment.\nThere isn’t a problem with nursing homes that do not offer these services to\ntheir residents. The homes that do not provide IV suite a need for a particular\npatient group of residents that do not require this treatment. <\/p>\n\n\n\n
If\nits possible, nursing homes should apply for approval to administer life-saving\ntreatments to residents. Having the ability to manage intravenous hydration and\nmedications can help prevent the resident from hospitalization.<\/p>\n\n\n\n
Peripheral intravenous (IV) catheters allow for the safe infusion of medications, hydration\/fluids, blood products, and nutritional supplements. (Robert L Frank, 2019) These IVs are meant for short periods of use. If a more extended period of intravenous hydration or antibiotics is required, the patient should have a different type of catheter placed.<\/p>\n\n\n\n
Antibiotic\nmedications can be used to treat multiple infections, including urinary tract\ninfections, pneumonia, upper urinary infections, or deep skin infections.<\/p>\n\n\n\n
IV\nantibiotics are not usually the first-line treatment. They are typically given\nwith more serious infections, absorption issues, and better bioavailability if\nthe medication in the body. There are also times when the patient is unable to\nswallow medications and must be administered via an alternate route.<\/p>\n\n\n\n
Many\nnursing homes provide training to their nurses in IV hydration and\nadministration of intravenous antibiotics. <\/p>\n\n\n\n
Studies\nshowed that nursing homes that provided this training in theory and practical\nintravenous treatment had positive outcomes for their patients. <\/p>\n\n\n\n
Nursing\nhomes need to develop training programs leading to sufficient expertise and\ncapacity of the nurses. By having proper training, the residents in need of\nintravenous fluids or antibiotics, ended up being treated locally rather than\nin the hospital.<\/p>\n\n\n\n
Now\nthat you know nursing homes administer all kinds of IV antibiotics and\nhydration, which would you prefer receiving your therapy? When you’re in the\nhospital, you are in a facility set up to handle mostly acute care issues and\nlife-threatening issues.<\/p>\n\n\n\n
Nursing\nhomes have the ideal setup for administering IV therapy. They are usually less\nchaotic, with fewer moving pieces when compared to a hospital. <\/p>\n\n\n\n
They have long-term care pharmacies that deliver your IV medications premeasured and ready to go. Plus, nursing homes are usually closer to your family members, allowing them to visit you during your stay.<\/p>\n\n\n\n
There\nwill be times when the hospital is the ideal setting. Certain intravenous\nmedications such as levophed, high volume IV hydration, and certain high-cost\nIV medications are best given in the hospital. <\/p>\n\n\n\n
Certain\nIV medications require a higher level of medical monitoring. This monitoring is\ndone by continuous monitoring of vitals by medical equipment and nursing and\nmedical staff. <\/p>\n\n\n\n
Dehydration can lead to serious problems for the patient. They are at an increased risk of urinary tract infections, increased falls, delirium, and confusion.<\/p>\n\n\n\n
Dehydration\nin the elderly is one of the common ailments affecting the elderly. Older\npersons often refuse to drink adequate amounts of fluid. <\/p>\n\n\n\n
Taking\nin enough water is essential when dealing with any person, never mind the\nelderly who are already at increased risk for dehydration.<\/p>\n\n\n\n
Unfortunately,\nmany elderly have dementia and are unable to voice their concerns to the\nmedical providers. <\/p>\n\n\n\n
If\na resident is unable to voice their needs, the nursing staff and CNAs must\ntrack the intake and output of the patient. This way, they can determine if the\npatient needs IV hydration. <\/p>\n\n\n\n
The\nelderly often have difficulty swallowing food and fluids (dysphagia). Suffering\nfrom dysphagia can lead to decreased fluid intake even if the resident tries to\nstay hydrated by drinking fluids. IV hydration can help supplement the\npatient’s fluid needs. <\/p>\n\n\n\n
Peripheral\nIVs have short cannulas (tubes the enter the skin and vein), which are easier\nto place and usually have fewer complications than longer cannula IVs. <\/p>\n\n\n\n
These\nPeripheral IVs are usually safer, with less chance of infection and less\npainful to place. <\/p>\n\n\n\n
Peripheral\nIVs should only be utilized when less invasive routes of administration could\nnot be used. If the provider can use the regular “PO” (by mouth) route\nof administration, then the provider should. <\/p>\n\n\n\n
These\nsort canula IVs are also safer with patients on medications like Coumadin,\nAspirin, and Plavix because they allow for direct pressure on the insertion\nsite to help stop the bleeding.<\/p>\n\n\n\n
Unfortunately,\nif the patient requires medications that are caustic to the veins or are going\nto be in place for a while, it is recommended that a central line be placed.<\/p>\n\n\n\n
There\nare medications such as vasopressors and certain antibiotics that can be\ncaustic and damaging to the blood vessels.<\/p>\n\n\n\n
Central\nlines can be used with patients that have a history of IV drug abuse due to\nabuse of their veins. It is also helpful with patients that are very\nchallenging to start a peripheral IV, such as someone severely dehydrated or\nfrail.<\/p>\n\n\n\n
A\nrather rare form of hydration to residents in the nursing home involves a\nrectal catheter. This method offers an easy route to provide medications and\nfluids quickly. This route is especially useful with difficult IV access.<\/p>\n\n\n\n
According\nto the authors, “This method of medication delivery provided a useful\nalternative treatment modality to address challenging medication and fluid\nadministration conditions.”<\/p>\n\n\n\n
“A\nlimb with a significant motor or sensory deficit may be used safely for\ntemporary placement of a peripheral IV catheter, provided the limb is monitored\nclosely until a preferable site for venous access can be found.” (Robert L\nFrank, 2019)<\/p>\n\n\n\n
I\nhave not found any nursing homes that utilize a rectal catheter for\nadministering hydration to its residents. Just because I have not had experience\nwith rectal hydration doesn\u2019t mean that it doesn\u2019t occur. There are studies\nthat show this route is a safe method of providing hydration to the resident. (Bob Parker & Siegfried Kreis, 2018)<\/p>\n\n\n\n
Overall, rectal tube hydration appears reserved for the hospital setting. <\/p>\n\n\n\n
When done correctly, there are not many worries regarding peripheral IV treatment. There are sometimes when there may be some concerns regarding IV therapy.<\/p>\n\n\n\n
If the staff placing the IV has not been properly trained in the placement of the PIV, this can lead to poor outcomes with the line. <\/p>\n\n\n\n
Another concern is the location the IV will be placed on the patient. For instance, there is some evidence regarding avoiding starting IVs on patients’ paralyzed arm.<\/p>\n\n\n\n
Starting PIV on the lower extremities should be avoided at all times while in the nursing home. It is best to reserve IVs to areas other than the arms\/hands to the hospitals.<\/p>\n\n\n\n\n
There\nare certain times when it can be more challenging for the nurse to place a\nperipheral IV. The two top reasons are obesity and poor venous access. <\/p>\n\n\n\n
Some\nelderly residents have fragile skin\/veins, which can make it challenging to\nplace the IV. Obese residents are challenging at times due to difficulty in\nlocating the vein for IV access.<\/p>\n\n\n\n
Other\ntimes for you to be concerned include getting a nurse who doesn’t have much\nexperience and training placing peripheral IVs. The nurse may struggle to\nlocate and place the IV resulting in multiple “sticks” of the\npatients. They may also overshoot the vein or not consider the presence of\nnerves.<\/p>\n\n\n\n
Sometimes\nthe veins are not visible to the provider attempting to place a PIV. When the\nveins are difficult to locate, it creates a challenge for all levels of trained\nstaff. <\/p>\n\n\n\n
Some\nfacilities have infrared light pens, which reflects everything but the vein\nitself. There are doppler ultrasound guidance devices, but this is usually\nreserved for central line placement.<\/p>\n\n\n\n
Just\nbecause a vein is large, doesn’t mean it is a suitable vein for IV access.\nSometimes these veins are firm from being accessed multiple times either from\nblood draws or history of IV drug use. <\/p>\n\n\n\n
If\na vein was recently accessed, the provider should look for an alternative site.\nYou want to give the veins a chance to heal before reaccessing the vein. <\/p>\n\n\n\n
When\nthere is swelling at the site or bruising, it is recommended that another IV\nsite be selected. There are increased risks for bleeding and clots when there\nis phlebitis at the site.<\/p>\n\n\n\n
When\nyou know that the nursing home will be starting a new peripheral IV, you may\nwant to prepare ahead of time. Some of the things you can do as a patient\ninclude<\/p>\n\n\n\n
Nursing\nhomes do administer IV hydration and intravenous antibiotics to their patients.\nThere are specific steps the facility had to take to get approvals to offer IV\ntherapy. <\/p>\n\n\n\n
Some\nfacilities chose not to offer IV therapy, which can work for certain types of\nnursing homes. Most patients will never need to receive intravenous therapy, so\nthese homes still do well.<\/p>\n\n\n\n
It\nis important to ask the admissions person at the nursing home you are thinking\nabout going to identify their services. If you feel you may potentially need IV\ntherapy, you should go to a nursing home that offers this service.<\/p>\n\n\n\n
<\/p>\n\n\n\n\n
<\/p>\n\n\n\n
Macy\nCatheter. Nursing Home Residents: Addressing Dehydration. https:\/\/www.macycatheter.com\/nursing-home-residents-addressing-dehydration\/<\/a> Retrieved December 10, 2019<\/p>\n\n\n\n
Provision\nof intravenous therapy in a skilled nursing facility. Journal of Intravenous Nursing.<\/a> 1991 Nov-Dec;14(6):366-70. MEDLINE https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/1748918<\/a> Retrieved December 10, 2019<\/p>\n","protected":false},"excerpt":{"rendered":"
