Receiving intravenous (IV) antibiotics does not always require remaining in a hospital or traveling to an infusion center for every dose. For some patients, a healthcare provider may determine that IV antibiotic treatment can be appropriately continued at home with skilled nursing and other healthcare support.
This type of treatment is often referred to as outpatient parenteral antimicrobial therapy (OPAT). The Infectious Diseases Society of America (IDSA) recognizes home-based treatment as one model for providing OPAT when appropriate patient selection, monitoring, vascular-access care, and healthcare-team support are in place.
At First Care Home Services, we provide skilled nursing and home infusion support throughout Miami-Dade and Broward County, Florida. Our nurses work with patients, families, physicians, infusion pharmacies, and other members of the healthcare team to provide physician-ordered care in the home.
If you or a loved one has been referred to First Care for IV antibiotic therapy, understanding what to expect can make the transition home easier.
What Are IV Antibiotics at Home?
IV antibiotics are medications administered directly into the bloodstream through vascular access such as a peripheral IV, midline, peripherally inserted central catheter (PICC), central venous catheter, or implanted port.
MedlinePlus, a service of the U.S. National Library of Medicine, explains that some patients can receive IV treatment at home and that vascular-access devices may remain in place during treatment depending on the therapy prescribed.
The decision to use IV antibiotics at home is made by the patient’s treating healthcare provider. The specific antibiotic, dose, frequency, infusion duration, vascular-access device, laboratory testing, and overall length of treatment depend on the patient’s condition and prescribed treatment plan.
Starting Home IV Therapy with First Care
When First Care receives a referral for home infusion nursing, our team reviews the physician’s orders and coordinates the skilled nursing services required under the patient’s plan of care.
Depending on the order and individual treatment plan, First Care’s nursing services may include IV medication administration, vascular-access assessment and care, dressing changes, laboratory specimen collection when ordered, medication monitoring, and patient or caregiver education.
First Care’s current skilled-nursing services include IV administration, medication management and monitoring, wound care, dressing changes, and catheter care.
The goal is to help the patient receive the ordered treatment while maintaining communication with the healthcare professionals involved in the patient’s care.
What Does a First Care Infusion Nurse Do?
Home infusion nursing involves more than administering an antibiotic.
During a scheduled visit, the First Care nurse follows the physician’s orders and individualized plan of care. Depending on the patient’s needs, nursing care may include:
- Administering prescribed IV antibiotics
- Assessing PICC lines and other vascular-access devices
- Central-line and implanted-port care
- Peripheral IV management
- Sterile dressing changes as ordered
- Assessing the IV site for potential complications
- Monitoring the patient’s response to treatment
- Collecting ordered laboratory specimens
- Providing patient and caregiver education
- Communicating significant findings to the appropriate healthcare provider
First Care also provides educational resources addressing IV administration, PICC access, central-line dressing changes, and implanted-port access.
What to Expect During an Infusion Nursing Visit
Each patient’s visit will depend on the medication, physician’s orders, vascular access, and plan of care.
Before administering the medication, the nurse may assess the patient’s condition, obtain vital signs when appropriate, review symptoms, and examine the vascular-access site.
Patients should tell the nurse about new or worsening symptoms, including fever or chills, unusual weakness, nausea or vomiting, diarrhea, rash or itching, shortness of breath, pain, or changes around the IV access.
Even when a symptom seems minor, informing the nurse allows the healthcare team to determine whether further assessment or intervention may be necessary.
Caring for a PICC Line, Port, or Other IV Access
Many patients receiving longer courses of IV antibiotics have a PICC line or another type of vascular-access device.
Proper care of these devices is important because intravascular catheters can create a pathway for infection and may also develop other complications.
CDC recommendations emphasize hand hygiene and aseptic technique during intravascular-catheter insertion and care. The CDC also recommends replacing catheter-site dressings if they become damp, loose, or visibly soiled and monitoring the site for possible complications.
During First Care nursing visits, the nurse may assess the vascular-access area for changes such as redness, swelling, warmth, tenderness, drainage, bleeding, leaking, dressing problems, or difficulty using the line.
MedlinePlus similarly advises patients with PICC lines to report problems including redness, swelling, bleeding, drainage, leaking, difficulty flushing the catheter, fever, or chills.
Patients and caregivers should follow the instructions provided by their healthcare team and should not independently attempt to repair or reposition a vascular-access device.
Safe Administration of IV Antibiotics
IV antibiotics should be administered according to the prescribing healthcare provider’s orders.
This includes the prescribed medication, dose, route, frequency, and infusion duration. Patients and caregivers should not independently change the antibiotic dose, infusion rate, schedule, or duration of therapy.
The CDC advises patients to take antibiotics exactly as prescribed and to notify their healthcare professional if side effects develop.
During nursing visits, First Care nurses follow the patient’s orders and appropriate infection-control practices while monitoring for significant changes or complications.
Monitoring for Medication Side Effects and Reactions
Medication-related adverse effects can develop during IV antibiotic therapy, even when earlier doses have been tolerated.
IDSA’s OPAT guideline emphasizes the importance of monitoring patients for antimicrobial-related adverse events throughout outpatient therapy.
Patients should promptly report new or worsening symptoms such as rash, itching, hives, unusual swelling, dizziness, persistent nausea or vomiting, worsening diarrhea, unusual weakness, breathing difficulties, or other significant changes in their condition.
The appropriate response depends on the medication, symptoms, severity, and patient’s treatment plan.
Difficulty breathing, swelling of the face or throat, severe chest pain, loss of consciousness, or another medical emergency requires immediate emergency assistance. Call 911.
Why Laboratory Monitoring May Be Necessary
Laboratory monitoring is an important component of many home IV antibiotic treatment plans.
IDSA recommends serial laboratory testing for patients receiving OPAT, although the specific tests and frequency depend on the antimicrobial medication and individual clinical circumstances.
Laboratory testing may help the treating healthcare team evaluate factors such as the patient’s response to therapy and potential medication-related complications.
When ordered, First Care nurses may collect laboratory specimens in the home and coordinate the required information with the appropriate healthcare providers or laboratory according to the patient’s plan of care.
Patients should keep all scheduled laboratory appointments and follow the testing instructions provided by their healthcare team.
Infection Prevention at Home
Preventing infection is particularly important when a patient has a PICC line, central venous catheter, implanted port, wound, or another medical device.
First Care nurses reinforce infection-prevention practices with patients and caregivers. Depending on the treatment plan, education may include proper hand hygiene, protecting the vascular-access dressing, keeping supplies clean and organized, following instructions for bathing, avoiding unnecessary manipulation of the catheter, and recognizing changes that should be reported.
CDC catheter guidance supports careful hand hygiene, aseptic catheter care, appropriate dressing management, and ongoing observation of vascular-access sites.
Patients should report fever, chills, new redness, tenderness, swelling, drainage, or other concerning changes according to the instructions provided by their healthcare team.
Communication Is an Important Part of Home Infusion Care
Home IV antibiotic therapy frequently involves several healthcare professionals.
Depending on the patient’s circumstances, the care team may include the prescribing physician, infectious-disease specialist, infusion pharmacy, home health nurse, laboratory, hospital or discharge team, patient, and family caregiver.
IDSA’s OPAT guidance emphasizes the importance of appropriate monitoring systems that allow vascular-access complications and antimicrobial adverse events to be identified during treatment.
When a First Care nurse identifies a significant clinical change, the nurse communicates findings to the appropriate healthcare professional according to the physician’s orders, agency procedures, and patient’s plan of care.
The Patient and Family’s Role
Patients and caregivers are also important members of the home infusion team.
Following the treatment schedule, keeping medications stored according to pharmacy instructions, maintaining clean supplies, practicing proper hand hygiene, protecting the vascular-access device, completing ordered laboratory testing, and keeping nursing and medical appointments can all contribute to proper management of home therapy.
Patients and caregivers should also ask questions whenever instructions are unclear and report new symptoms promptly.
The goal of education is not to make patients responsible for making clinical decisions. It is to help them understand their prescribed treatment, recognize potential problems, and know when to contact the appropriate healthcare professional.
When Should You Contact First Care or Your Healthcare Provider?
Follow your individualized instructions for contacting your First Care nurse, physician, infusion pharmacy, or other healthcare professional.
Changes that may need to be reported include fever or chills, new rash or itching, increasing weakness, unusual drainage, redness or swelling around the IV site, problems with the catheter or dressing, medication concerns, or symptoms of the underlying infection that appear to be worsening.
However, home health services do not replace emergency medical care.
Sepsis, for example, is a life-threatening medical emergency caused by the body’s extreme response to an infection. CDC guidance stresses the importance of obtaining medical care immediately when sepsis is suspected.
For severe breathing difficulty, severe chest pain, loss of consciousness, severe confusion, signs of a severe allergic reaction, suspected sepsis, or another medical emergency, call 911 immediately. Do not wait for the next scheduled nursing visit.
Home Infusion Nursing with First Care Home Services
Transitioning from a hospital or infusion setting to home IV therapy can involve new medications, equipment, vascular-access care, laboratory testing, and instructions.
First Care Home Services supports eligible patients with physician-ordered skilled nursing services that may include:
- IV antibiotic administration
- PICC and central-line care
- Implanted-port care
- IV medication administration
- Sterile dressing changes
- Ordered laboratory specimen collection
- Medication monitoring
- Patient and caregiver education
- Communication with members of the healthcare team
Care is based on each patient’s physician orders, clinical needs, and individualized plan of care.
First Care Home Infusion Services in Miami-Dade and Broward County
First Care Home Services provides skilled nursing services, including IV administration, to patients in Miami-Dade and Broward County.
Whether a patient is transitioning home following hospitalization, beginning a physician-ordered course of IV antibiotics, or requires ongoing vascular-access nursing care, our team can coordinate with the patient’s healthcare providers and infusion pharmacy regarding ordered home nursing services.
Learn more about First Care Home Services’ skilled nursing care
Contact First Care Home Services to learn more about available home infusion and skilled nursing services in Miami-Dade and Broward County.
References
Infectious Diseases Society of America (IDSA). Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy. This guideline addresses OPAT patient selection, vascular access, antimicrobial monitoring, adverse events, and laboratory monitoring.
IDSA OPAT Clinical Practice Guideline
Centers for Disease Control and Prevention (CDC). Strategies for Prevention of Catheter-Related Infections in Adult and Pediatric Patients. Guidance regarding hand hygiene, aseptic technique, catheter-site care, dressing management, and infection prevention.
CDC Intravascular Catheter Infection Prevention Guidance
MedlinePlus, U.S. National Library of Medicine. IV Treatment at Home. Patient guidance addressing home IV therapy, vascular-access devices, monitoring, and when to contact a healthcare professional.
MedlinePlus — IV Treatment at Home
MedlinePlus, U.S. National Library of Medicine. Peripherally Inserted Central Catheter (PICC) — Dressing Change. Patient guidance regarding PICC-line care and symptoms that should be reported.
MedlinePlus — PICC Line Care
Centers for Disease Control and Prevention (CDC). About Sepsis. Information regarding sepsis, warning signs, and the need for immediate medical attention.
CDC — About Sepsis
First Care Home Services. Skilled Nursing Care. Information about First Care’s skilled nursing services and service area.
First Care Home Services — Skilled Nursing Care
This article is provided for general educational purposes and is not a substitute for professional medical advice, diagnosis, treatment, or emergency medical care. Home infusion eligibility and treatment are determined by the patient’s healthcare providers and applicable orders. Always follow the instructions provided by your physician, pharmacist, nurse, and healthcare team. In a medical emergency, call 911.