Malignant Ascites Management Economics
|
|
- Jessie Lane
- 7 years ago
- Views:
Transcription
1 Malignant Ascites Management Economics Peri Booth Sr. Manager-Health Economics 75 N Fairway Dr., Vernon Hills, IL cell office Peri.Booth@CareFusion.com 2015 CareFusion Corporation or one of its subsidiaries. All rights reserved.
2 Discussion Who is the ascites patient CareFusion s insight Ascites management; 3 perceptions Clinical discussion Final thoughts Questions 2
3 Routine Paracentesis ROOM SCHEDULE Proc Room TIME PATIENT/AGE* IR NAME ATTENDING ANES TYPE PROCEDURE REMARK RN Powers, John M-45 Kumar, O Sendler, T Local Liver Biopsy Tomey, J Smith, Francine: F-67 Jones, F Richter, S Local Paracentesis repeat Wilson, B Kelly, Linda F-61 Logan, L Ward, W Local Lumbar Puncture Latex allergy Larsen, E *Hypothetical names 3
4 Repeat Paracentesis Patients 4
5 This Is The Reality 5
6 20 Taps < 5 months 6
7 Patient Perspective 7
8 How is CareFusion Addressing the Issue? CareFusion is working with facilities to provide value analysis tools they need Clinical protocol Patient engagement Financial impact Reviewing hospital claims data Sharing best practices Insight in why facilities choose protocols 8
9 Not all Indwelling Tunneled Catheters are the same 4 indwelling tunneled catheter products are available on the market today CareFusion PleurX Bard Aspira B. Braun Asept Rocket Medical Carefusion s Pleurx catheter system provides clinically proven results The only system with a pleurodesis indication CareFusion Corporation or one of its subsidiaries. All rights reserved.
10 200+ Hospitals: What Have We Learned? 75% are losing $$ on outpatient paracentesis Avg $600 loss per procedure Over 50% of total cost is tied to time No facility performing outpatient PleurX procedures lost $$ Avg. $1000 Higher Medicaid/Medicare %, tend to have higher costs Ahd.com/2012
11 3 Perceptions in Regard to Placing PleurX : Performing a paracentesis costs the facility less Paracentesis is a more efficient use of time The patient out-of-pocket for PleurX bottles is too high 11
12 Paracentesis Costs a Facility Less to Perform? Large Volume Paracentesis (LVP) can tie up room and staff 3 hours Paracentesis supplies may cost less but they cost more to perform Re-Encounters increase risk of HACs and re-admissions Patients often present in the ED to be drained 1. Courtney, A, Nemcek AA, Rosenber S, Tutton S, Darcy M, Gordon G. Prospective Evaluation of the PleurX Catheter When Used to Treat Recurrent Ascites with Malignancy. J Vasc Interv Radio 2008;19: Rosenberg S, Courtney A, Nemcek Jr AA, Omary R. Comparison of Percutaneous Management Techniques for Recurrent Malignant Ascites. J Vascular Interv Radiol 2004;15: MTG9 PleurX peritoneal catheter drainage system for vacuum assisted drainage of treatment resistant recurrent malignant ascites: Issued March London: National Institute for Health and Clinical Excellence. 111.cms.gov 12
13 Typical 2013 Example CPT Insert tun ip cath perc CPT Abd paracentesis w/imaging Total Payment # Patient Claims Units of Service Average Charge per Unit Average Cost per Unit Average Payment per Unit Total Payment # Patient Claims Units of Service Average Charge per Unit Average Cost per Unit Average Payment per Unit $26, $3,230 $1,315 $2,403 $25, $2,327 $1,087 $
14 More Efficient Use of Time and Space? Large volume paracentesis can tie up space up to 3 hours PleurX system (IPC) Medicare Work RVUs are more than double paracentesis work RVUs Patient bonding? 14
15 What Does it Take to Get this Patient to the Hospital? Near end of life Exhausted Difficult to move Difficult to breathe Bathing hurts They hurt in every position Just touching them hurts
16 Patient Out-of-Pocket for Pleurx Placement Too High? Copay/co-insurance for every encounter Only one percutaneous access with PleurX Catheter Patient responsibility for one admission due to paracentesis complication is far greater than an outpatient PleurX placement Potential loss for the facility $600 X
17 Patient Out-of-Pocket for Pleurx Bottles Too High? Review of 29 claims from a major cancer center 25 patients were covered at 100% 4 of 29 patients had a co-pay (avg. < $100) Data per EdgePark 11/ /2013 for MSKCC 17
18 PleurX Proven catheter system Highly effective with low complication rates Symptom relief % of patients, weekly declaration of ascites symptom control (34 malignant ascites patients, Courtney 08) Infection rates 1% (2 / 188) patients with peritonitis additionally, 1.6% (3/188 patients had cellulitis (188 ascites patients, Lungren 13) o o 0% (0 / 28) patients with peritonitis Additionally, 5 cases of erythema resolved with 7 day antibiotics course (28 malignant ascites patients, Tapping 11) Occlusion / Blockage 10% (3/34) occlusion (34 malignant ascites patients, Courtney 08) 2.5% (5/188) catheter malfunction (188 ascites patients, Lungren 13) Patient Quality of Life: Nutritional State Minimal protein loss with PleurX, compared to large volume paracentesis; Study showed no change in serum albumin over 12 weeks of PleurX drainage (34 malignant ascties patients, Courtney 08)
19 What About Patient Quality of Life? Patients prefer PleurX* Fewer visits More quality time with family Fewer needle sticks Continual control helps avoid discomfort instead waiting until next scheduled para visit. Repeat Paracentesis = more encounters & risk of HACs *PleurX Peritoneal Catheter Drainage System for Vacuum-Assisted Drainage of Treatment-Resistant, Recurrent Malignant Ascites: A NICE Medical Technology Guidance Judith White and Grace Carolan-Rees Cedar, Cardiff and Vale University Health Board, Cardiff, Wales 19
20 What About Patient Quality of Life? Difficulty coordinating logistics for repeat paracentesis. Caregiver to drive them Family member who takes a day off from work Cost of parking, taxis, gas Often patients wait until they need emergency care Additional complications Ambulance costs ER space *PleurX Peritoneal Catheter Drainage System for Vacuum-Assisted Drainage of Treatment-Resistant, Recurrent Malignant Ascites: A NICE Medical Technology Guidance Judith White and Grace Carolan-Rees Cedar, Cardiff and Vale University Health Board, Cardiff, Wales 20
21 Ascites Management via Repeat Paracentesis: What this means to a patient 20% or 2.5 weeks Life Expectancy = 12 weeks Quality Time with Family Draining at a Facility Based on 2 days spent of every 10 days draining via a Facility
22 Some Clinical Considerations 2015 CareFusion Corporation or one of its subsidiaries. All rights reserved.
23 PleurX Catheter PleurX Catheter Pleural Peritoneal 15.5 Fr. silicone catheter conforms to the pleural space Valve prevents inadvertent passage of air or fluid through the catheter Polyester cuff promotes tissue ingrowth to reduce infection risk and hold the catheter securely in place Fenestrated portion promotes drainage
24 Drainage kit components Vacuum bottle with drainage line attached Blue wrap (not shown) Latex-free gloves, qty. 2 Gauze pads, qty. 4 Alcohol pads, qty. 3 Foam pad Waterproof dressing Valve cap Blue emergency clamp
25 Potential PleurX System Team Members Physicians Thoracic Surgeons Interventional Radiologists Interventional Pulmonologists Medical Oncologists Nurses Clinic/office nurse Nurse navigator CNS/nurse educator Case managers Home care/hospice Interventional radiology Member of palliative care team
26 Checklist For Success Have you provided: Patient teaching: Use of the catheter, drainage procedure, troubleshooting, frequently asked questions and obtaining supplies? Warnings about the catheter and drainage procedure (such as not reusing supplies)? An opportunity for patient and caregiver to watch the drainage? Time for the patient or caregiver to verbally review the drainage procedure, correcting any mistakes? Discharge supplies to bridge the period between discharge and delivery of supplies from DME provider?
27 Supplemental Patient Resources Brochures & DVD Step-by-step instructional wall chart Drainage log
28 PleurX Patient Starter Kit Patient information kit components Starter kit components Patient education DVD Introductory letter with ordering information Frequently asked questions (FAQ) brochure Instructions for Use booklet Reference wall chart Emergency information card Drainage log PleurX drainage kits, including 1,000 ml bottles and procedure packs (qty. 4) Convenient carrying box Patient information kit
29 Educational Resources Clinical Education Clinical Consultants Work to develop and execute a training and education plan Per-diem Nurse educators, Provide PleurX product in-servicing in your hospital. CNE Programs - There are accredited CNE programs about Ascites/Effusion Management that can be used for Grand Rounds, Interventional radiology nurses, ONS Chapter Meetings, and other venues Contact your CareFusion Sales Representative to Discuss Assistance with Policy and Procedures
30 PleurX Support Team Customer service: To order educational materials For clinical questions, ask to be connected to a clinical nurse consultant or your local sales rep EdgePark Medical Supplies: To order patient supplies for home drainage Ask to speak with a PleurX Specialist PleurX website Patients: carefusion.com/pleurxpatient Nurses: carefusion.com/medical-products/interventionalprocedures/drainage/pleurx/nurses/
31 Patient Perspective This option is saving them time and keeping him more comfortable. My dad s abdominal catheter has been in place slightly over 2 weeks. He has said that draining it incrementally instead of once weekly makes him feel better
32 Patient Perspective
33 Final Thoughts Patients prefer PleurX* Fewer visits More quality time with family Fewer needle sticks Continual control helps avoid discomfort instead waiting until next scheduled para visit. Fewer co-pays and insurance claims. Repeat Paracentesis = more encounters & risk of HACs Can help streamline process for facilities Can assist in keeping patients out of the facility Helps get patients off the repeat cycle CareFusion Corporation or one of its subsidiaries. All rights reserved.
34 Questions? Peri Booth Sr. Manager-Health Economics 75 N Fairway Dr., Vernon Hills, IL cell office Peri.Booth@CareFusion.com Bradley Archer, RN BSN Senior Quality Care Consultant Interventional Specialties. Mobile: bradley.archer@carefusion.com 2015 CareFusion Corporation or one of its subsidiaries. All rights reserved.
Aspira* Peritoneal Drainage Catheter
Aspira* Peritoneal Drainage Catheter Instructions For Use Access Systems Product Description: The Aspira* Peritoneal Drainage Catheter is a tunneled, long-term catheter used to drain accumulated fluid
More informationcatheter system catalog PleurX PleurX
PleurX catheter system catalog New indication: The PleurX pleural catheter can be used in place of a chest tube to deliver talc slurry or bleomycin, giving you an additional treatment option. Help your
More informationCaring for Your PleurX Pleural Catheter
Caring for Your PleurX Pleural Catheter A PleurX Pleural Catheter has been placed in your chest through a small incision in your skin into the pleural space (see picture below). This allows you to drain
More informationInformation for patients and nurses
Information for patients and nurses Rocket IPC Pleural Catheter Indwelling Catheter Rocket Indwelling Pleural Catheter (IPC) Contents Contact Information...03 What s in the Rocket Dressing Pack and Bottle
More informationPATIENT GUIDE. Care and Maintenance Drainage Frequency: Max. Drainage Volume: Dressing Option: Clinician s Signature: Every drainage Weekly
PATIENT GUIDE Care and Maintenance Drainage Frequency: Max. Drainage Volume: Dressing Option: Every drainage Weekly Clinician s Signature: ACCESS SYSTEMS Pleural Space Insertion Site Cuff Exit Site Catheter
More informationPATIENT GUIDE. Care and Maintenance Drainage Frequency: Max. Drainage Volume: Dressing Option: Clinician s Signature: Every drainage Weekly
PATIENT GUIDE Care and Maintenance Drainage Frequency: Max. Drainage Volume: Dressing Option: Every drainage Weekly Clinician s Signature: ACCESS SYSTEMS Pleural Space Insertion Site Cuff Exit Site Catheter
More informationCaring for a Tenckhoff Catheter
Caring for a Tenckhoff Catheter UHN A Patient s Guide What is a Pleural Effusion? There is a small space between the outside of your lung and the chest wall (ribs). This space is called the pleural space.
More informationAspira* Pleural Drainage Catheter
Aspira* Pleural Drainage Catheter Instructions For Use Access Systems Product Description: The Aspira* Pleural Drainage Catheter is a tunneled, long-term catheter used to drain accumulated fluid from the
More informationPATIENT GUIDE. Understand and care for your peripherally inserted central venous catheter (PICC). MEDICAL
PATIENT GUIDE Understand and care for your peripherally inserted central venous catheter (PICC). MEDICAL Introduction The following information is presented as a guideline for your reference. The best
More informationPercutaneous Nephrostomy. Care of your Nephrostomy. Department of Urology
Percutaneous Nephrostomy Care of your Nephrostomy Department of Urology You may encounter some problems at home but these are usually easily overcome. Listed below are some questions patients commonly
More informationCare of Your Hickman Catheter
Care of Your Hickman Catheter Johns Hopkins Kimmel Cancer Center, Revised 7/11 Contents What is a Hickman Catheter? Page 3 Does the Catheter Limit My Activities? Page 4 How Do I Care for My Catheter? Page
More informationTunnelled indwelling pleural catheter (TIPC)
Tunnelled indwelling pleural catheter (TIPC) A patient s guide 1 What is a tunnelled indwelling pleural catheter? A tunnelled indwelling pleural catheter is a specially designed small tube to drain fluid
More informationPolicy and Procedure Flushing and / or Blood withdrawal Aspiration Procedure For PICC Line and Midline Catheters
Policy and Procedure Flushing and / or Blood withdrawal Aspiration Procedure For PICC Line and Midline Catheters Purpose: Blood Withdrawal: To obtain blood samples for laboratory evaluation, eliminating
More informationInstructions for Use
Pleural Effusion Shunt with External Pump Chamber Catalog No. 42-9005 Instructions for Use Denver Biomedical, Inc. Table of Contents Description 2 Indications 2 Contraindications 2 Warnings 4 Cautions
More informationUnderstanding your Peripherally Inserted Central Catheter (PICC) Patient Information
Understanding your Peripherally Inserted Central Catheter (PICC) Patient Information The Purpose of this Information Sheet This information sheet has been written by patients, members of the public and
More informationGoing home with your Tunneled Catheter
Going home with your Tunneled Catheter Your Tunneled Catheter was put in by on Interventional Radiologist Date Your Tunneled Catheter was put in at: McMaster University Medical Centre Hamilton General
More informationFact Sheet. Caring for and Changing your Supra-Pubic Catheter (SPC) Queensland Spinal Cord Injuries Service
and Caring for and Changing your Supra-Pubic Catheter (SPC) What is a Suprapubic Catheter? A supra-pubic catheter is a tube that goes into your bladder through your abdominal wall which continuously drains
More informationBiliary Drain. What is a biliary drain?
Biliary Drain What is a biliary drain? A biliary drain is a tube to drain bile from your liver. It is put in by a doctor called an Interventional Radiologist. The tube or catheter is placed through your
More informationSurgery. Wedge resection only part of the lung, not. not a lobe, is removed. Cancer Council NSW
The treatment you receive will depend on your lung cancer type, for example, whether you have a non-small cell lung cancer Adenocarcinoma or Squamous cell carcinoma, and if this is a sub-type with a mutation.
More informationPatient Information Guide Morpheus CT Peripherally Inserted Central Catheter
Patient Information Guide Morpheus CT Peripherally Inserted Central Catheter IC 192 Rev C A measure of flexibility and strength. Table of Contents 1. Introduction 2. What is the Morpheus CT PICC? 3. What
More informationTunneled Central Venous Catheter (CVC) Placement
PATIENT EDUCATION patienteducation.osumc.edu Tunneled Central Venous Catheter (CVC) Placement A tunneled Central Venous Catheter (CVC) is a special type of intravenous (IV) line that is placed into a large
More informationORDERING PROCEDURE for Asept Drainage Kit
ORDERING PROCEDURE for Asept Drainage Kit 1. All patients must submit completed forms listed below to (AMS): Letter of Medical Necessity (To be completed by Physician) Patient Information form Assignment
More informationCare for your child s Central Venous Catheter (CVC)
Care for your child s Central Venous Catheter (CVC) This booklet is intended for general informational purposes only. You should consult your doctor for medical advice. Please call the clinic or your home
More informationRed rubber all-purpose urethral. Catheters. Bard Clean-Cath Intermittent catheter: 802408-22 8-22 Fr. 100/case
BARDIA Urethral Catheters Red rubber all-purpose urethral catheters: Radiopaque red rubber catheter with a round, hollow tip Can be used as a Robinson or a Nelaton catheter Two opposing drainage eyes 16
More informationVUMC Guidelines for Management of Indwelling Urinary Catheters. UC Access/ Maintenance
VUMC Guidelines for Management of Indwelling Urinary Catheters UC Insertion Preparation & Procedure Indications for insertion and continued use of indwelling urinary catheters include: Urinary retention
More informationFlushing and Dressing a Peripherally Inserted Central Catheter (PICC Line): a Guide for Nurses
Flushing and Dressing a Peripherally Inserted Central Catheter (PICC Line): a Guide for Nurses Information for Nurses Introduction This information is for community nursing staffs who have been asked to
More informationPre-workshop exercise
Setting research priorities for mesothelioma workshop 10 th November 2014 Pre-workshop exercise Your individual ranking of unanswered questions about the diagnosis, treatment and care of mesothelioma Please
More informationAtrium Pneumostat Chest Drain Valve. Discharge Instructions
Atrium Pneumostat Chest Drain Valve Discharge Instructions Your Physician Name: Contact Number for Emergencies: Introduction Your physician has decided to change your chest drainage system to a smaller
More informationN26 Chest Tubes 5/9/2012
Thoracic cavity, pleural space 1 Conditions requiring chest drainage_1 Air between the pleurae is a pneumothorax Occurs when there is an opening on the surface of the lung or in the airways, y, in the
More informationRegions Hospital Delineation of Privileges Nurse Practitioner
Regions Hospital Delineation of Privileges Nurse Practitioner Applicant s Last First M. Instructions: Place a check-mark where indicated for each core group you are requesting. Review education and basic
More informationACI UROLOGY NETWORK - NURSING BLADDER IRRIGATION GUIDELINES
ACI UROLOGY NETWORK - NURSING BLADDER IRRIGATION GUIDELINES The following pages provide examples of clinical guidelines to enable clinicians to develop their own resource material relevant to their hospital
More informationPeripherally Inserted Central Catheter (PICC) for Outpatient
Peripherally Inserted Central Catheter (PICC) for Outpatient Introduction A Peripherally Inserted Central Catheter, or PICC line, is a thin, long, soft plastic tube inserted into a vein of the arm. It
More informationLaparoscopic Nephrectomy
Laparoscopic Nephrectomy Information for Patients This leaflet explains: What is a Nephrectomy?... 2 Why do I need a nephrectomy?... 3 What are the risks and side effects of laparoscopic nephrectomy?...
More informationHow prostate cancer is diagnosed
How prostate cancer is diagnosed This information is an extract from the booklet Having tests for prostate cancer. You may find the full booklet helpful. We can send you a free copy see page 7. Contents
More informationNew Cardiothoracic Surgery CPT Codes for 2013
New Cardiothoracic Surgery CPT Codes for 2013 There were several changes to the cardiothoracic surgery CPT codes for 2013. There are five new codes in the general thoracic surgery section, with one revised
More informationManaging your bladder with a suprapubic catheter at home
Managing your bladder with a suprapubic catheter at home Gateshead Primary Care Trust South Tyneside Primary Care Trust Sunderland Teaching Primary Care Trust What is a suprapubic catheter? A suprapubic
More informationMesenteric Angiography
Information for patients Mesenteric Angiography Sheffield Vascular Institute Northern General Hospital You have been given this leaflet because you need a procedure known as a Mesenteric Angiogram. This
More informationMANCHESTER Lung Cancer Screening Program Dartmouth-Hitchcock Manchester 100 Hitchcock Way Manchester, NH 03104 (603) 695-2850
LEBANON Lung Cancer Screening Program One Medical Center Drive Lebanon, NH 03756 (603) 650-4400 (866) 966-1601 Toll-free cancer.dartmouth.edu/lungscreening MANCHESTER Lung Cancer Screening Program Dartmouth-Hitchcock
More informationHICKMAN Catheter Care with a Needleless Connector
HICKMAN Catheter Care with a Needleless Connector Table of Contents Part 1 Learning about the HICKMAN Catheter... 2 Part 2 Caring for Your Hickman Catheter... 3 A. Preventing Infection... 3 B. Bathing...
More informationPressure Ulcers: Facility Assessment Checklists
Pressure Ulcers: Facility Assessment Checklists This is a series of self-assessment checklists for nursing home staff to use to assess processes related to managing pressure ulcers in the facility, in
More informationLymph Node Dissection for Penile Cancer
Lymph Node Dissection for Penile Cancer Exceptional healthcare, personally delivered Removal of Lymph Nodes Why are the Lymph Nodes so important when I have penile cancer? Lymph nodes are small bean shaped
More informationPercutaneous Abdominal or Pelvic Drain What to expect
Patient Education Percutaneous Abdominal or Pelvic Drain What to expect This handout explains what percutaneous abdominal or pelvic drain is and what to expect when you have one. What is a percutaneous
More informationPolicies & Procedures. I.D. Number: 1073
Policies & Procedures Title:: CENTRAL VENOUS CATHETERS INSERTION ASSISTING I.D. Number: 1073 Authorization [] Pharmacy Nursing Committee [] MAC Motion #: [x] SHR Nursing Practice Committee Source: Nursing
More informationPeripherally Inserted Central Catheter (PICC) Patient Instructions
Patient Care Services 300 Pasteur Drive Stanford, CA 94305 Peripherally Inserted Central Catheter (PICC) Patient Instructions A Peripherally Inserted Central Catheter (PICC) is a soft flexible tube inserted
More informationWithin the Scope of Practice/Role of APRN RN _ X_LPN CNA
Wyoming State Board of Nursing 130 Hobbs Avenue, Suite B Cheyenne, WY 82002 Phone (307) 777-7601 Fax (307) 777-3519 E-Mail: wsbn-info-licensing@wyo.gov Home Page: https://nursing-online.state.wy.us/ OPINION:
More informationCentral Venous Catheter Care For Haemodialysis
Central Venous Catheter Care For Haemodialysis Information For Parents and Carers Haemodialysis Unit 01 878 4757 Main Hospital Number 01 878 4200 Central Venous Catheters We hope this booklet will help
More informationV: Infusion Therapy. Alberta Licensed Practical Nurses Competency Profile 217
V: Infusion Therapy Alberta Licensed Practical Nurses Competency Profile 217 Competency: V-1 Knowledge of Intravenous Therapy V-1-1 V-1-2 V-1-3 V-1-4 V-1-5 Demonstrate knowledge and ability to apply critical
More informationGuy s, King s and St Thomas Cancer Centre The Cancer Outpatient Clinic Central venous catheter: Peripherally inserted central catheter
Guy s, King s and St Thomas Cancer Centre The Cancer Outpatient Clinic Central venous catheter: Peripherally inserted central catheter This information leaflet aims to help answer some of the questions
More informationA PATIENT S GUIDE TO ABLATION THERAPY
A PATIENT S GUIDE TO ABLATION THERAPY THE DIVISION OF VASCULAR/INTERVENTIONAL RADIOLOGY THE ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL Treatment options for patients with cancer continue to expand, providing
More informationCatheter Care. What you need to know. Jacinta Stewart Continence Nurse
Catheter Care What you need to know Jacinta Stewart Continence Nurse Indications for Long Term Catheter Use Long term urinary catheters should only be used with clients who cannot satisfactorily be managed
More informationHemodialysis Access: What You Need to Know
Hemodialysis Access: What You Need to Know Hemodialysis Access: What You Need To Know Whether you already get hemodialysis treatment, or you will need to start dialysis soon, this booklet will help you
More informationPATIENT URINARY CATHETER PASSPORT
n PATIENT URINARY CATHETER PASSPORT A guide on how to look after your Catheter NHS Hertfordshire Patient Experience Team Charter House Parkway Welwyn Garden City Hertfordshire AL8 6JL Telephone: 01707
More informationLocation: Clinical Practice Manual
Subject: Area: Classification: Relevant to: Bladder Management Clinical Practice All Clinical Staff Implementation Date: March 2001 Review Date: March 2004 Responsible for Review: Approved by: Distribution:
More informationPatient information on endoscopic mucosal resection (EMR) (Endoscopic removal of polyps) Your questions answered
Patient information on endoscopic mucosal resection (EMR) (Endoscopic removal of polyps) Your questions answered Page 1 of 7 Contents What is a colonic polyp Page 3 What is an endoscopic mucosal resection
More informationNHS. Percutaneous endoscopic colostomy. National Institute for Health and Clinical Excellence. Issue date: March 2006
NHS National Institute for Health and Clinical Excellence Issue date: March 2006 Percutaneous endoscopic colostomy Understanding NICE guidance information for people considering the procedure, and for
More informationColon Cancer Surgery and Recovery. A Guide for Patients and Families
Colon Cancer Surgery and Recovery A Guide for Patients and Families This Booklet You are receiving this booklet because you will be having surgery shortly. This booklet tells you what to do before, during,
More informationI. Questions for VAD slide program
I. Questions for VAD slide program 1. The rate of central line associated blood stream infections (CLABSI) in the adult ICUs in Johns Hopkins Hospital is lower than the national average. 2. The mortality
More informationWhat If I Have a Spot on My Lung? Do I Have Cancer? Patient Education Guide
What If I Have a Spot on My Lung? Do I Have Cancer? Patient Education Guide A M E R I C A N C O L L E G E O F C H E S T P H Y S I C I A N S Lung cancer is one of the most common cancers. About 170,000
More informationHow to care for a Midline Catheter
How to care for a Midline Catheter Developed by the health care professionals of the IV Program with assistance from the Department of Learning and Development. All rights reserved. No part of this book
More informationA4.7 Management of a totally occluded central catheter and persistent withdrawal occlusion (PWO)
A4.7 Management of a totally occluded central catheter and persistent withdrawal occlusion (PWO) Types of Catheter Related Thrombotic A catheter-related thrombus may be intraluminal (inside the catheter)
More informationThe Global Surgery Package Part I. Riva Lee Asbell
The Global Surgery Package Part I Riva Lee Asbell Introduction One of the least understood concepts in surgical coding concerns the details involved in the Global Surgery Package. Some of the rules were
More informationPeripherally Inserted Central Catheter (PICC)
Patient information leaflet Royal Surrey County Hospital NHS Foundation Trust Peripherally Inserted Central Catheter (PICC) Intravenous Therapy What is a PICC? A PICC is a very fine flexible tube measuring
More informationPICC & Midline Catheters Patient Information Guide
PICC & Midline Catheters Patient Information Guide medcompnet.com 1 table of contents Introduction 4 What is a PICC or Midline Catheter? 4 How is the PICC or Midline Catheter Inserted? 6 Catheter Care
More informationClinician Competency:
Thanks to CR Bard Clinician Competency: INS (Intravenous Nursing Society) recommends that an institution create a set criteria to evaluate the competency of nurses learning to place PICC Line / Midline
More informationPage 1 of 10 MC1482 Peripherally-Inserted Central Catheter. Peripherally-Inserted Central Catheter (PICC)
Page 1 of 10 MC1482 Peripherally-Inserted Central Catheter Peripherally-Inserted Central Catheter (PICC) Page 2 of 10 MC1482 Peripherally-Inserted Central Catheter Introduction A peripherally-inserted
More informationAre venous catheters safe in terms of blood tream infection? What should I know?
Are venous catheters safe in terms of blood tream infection? What should I know? DIAGNOSIS, PREVENTION AND TREATMENT OF HAEMODIALYSIS CATHETER-RELATED BLOOD STREAM INFECTIONS (CRBSI): A POSITION STATEMENT
More informationUrology Extended Care
Urology Extended Care Urology Extended Care Covidien s mission is to provide quality urological devices delivering powerful benefits to physicians, caregivers, and patients. Covidien offers a comprehensive
More informationRound Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma
Round Table with Drs. Anne Tsao and Alex Farivar, Case 2: Mesothelioma I d like to welcome everyone, thanks for coming out to our lunch with experts. The faculty today are great people in the thoracic
More informationExcision or Open Biopsy of a Breast Lump Your Operation Explained
Excision or Open Biopsy of a Breast Lump Your Operation Explained Patient Information Introduction This leaflet tells you about the procedure known as excision or open biopsy of a breast lump. It explains
More informationPICCs and Midline Catheters
Patient Education PICCs and Midline Catheters Patient s guide to PICC (peripherally inserted central catheter) and midline catheters What are PICCs and midline catheters used for? Any medicine given over
More informationTHORACIC DIAGNOSTIC ASSESMENT PROGRAM (DAP) PATIENT INFORMATION FOR:
central east regional cancer program in partnership with cancer care ontario THORACIC DIAGNOSTIC ASSESMENT PROGRAM (DAP) PATIENT INFORMATION FOR: Thoracic dap booklet March2012.indd 1 SCHEDULED TESTS YOUR
More informationGastroschisis and My Baby
Patient and Family Education Gastroschisis and My Baby Gastroschisis is a condition where a baby is born with the intestine outside the body. Learning about the diagnosis What is gastroschisis? (pronounced
More informationFlushing and Dressing a Peripherally Inserted Central Catheter (PICC Line)
Flushing and Dressing a Peripherally Inserted Central Catheter (PICC Line) Patient Information Introduction This booklet has been written to provide information to patients with a Peripherally Inserted
More informationThe Argon Family of PICC and Midline Catheters. Providing Optimal Outcomes for Long-Term & Intermediate Therapies
The Argon Family of PICC and Midline Catheters Providing Optimal Outcomes for Long-Term & Intermediate Therapies Introducers Safety MST Accessory Kits Safety MST Accessory Kits for PICC and Midline Placement
More informationHospice Certification, Care Planning and Documentation:
Hospice Certification, Care Planning and Documentation: Created by: Created by: Brenda Lovelady, Liberty Hospital Hospice Presented by: Robin Carnett, Heartland Hospice Hospice Certification Written certification
More informationPATIENT CARE MANUAL PROCEDURE
PATIENT CARE MANUAL PROCEDURE NUMBER VII-E-5 PAGE 1 OF 7 APPROVED BY: CATEGORY: Tri-site Nursing Policy and Procedures Review Committee Body Systems; Genitourinary 1.0 GOALS To influence patient care providers
More informationCHEST TUBES AND CHEST DRAINAGE SYSTEMS
CHEST TUBES AND CHEST DRAINAGE SYSTEMS Central Nursing Orientation April 2008 Revised September 2011 OBJECTIVES Describe common tubes and indications for use at LHSC Review indications and contraindications,
More informationSTANDARDIZED PROCEDURE BONE MARROW ASPIRATION
I. Definition: This protocol covers the task of bone marrow aspiration by an Allied Health Professional. The purpose of this standardized procedure is to allow the Allied Health Professional to safely
More informationX-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary
X-Plain Subclavian Inserted Central Catheter (SICC Line) Reference Summary Introduction A Subclavian Inserted Central Catheter, or subclavian line, is a long thin hollow tube inserted in a vein under the
More informationIntegumentary System Individual Exercises
Integumentary System Individual Exercises 1. A physician performs an incision and drainage of a subcutaneous abscess in his office for a particularly uncooperative established patient. How should this
More informationPeripherally Inserted Central Catheter (PICC) Benefits Long-term access - dwell time varies (can be > one year) Decreased length of stay in hospital a
Nursing Management of Venous Access Devices: Peripherally Inserted Central Catheter (PICC) Mimi Bartholomay, RN, MSN, AOCN Denise Dreher, RN, CRNI, VA-BC Theresa Evans, RN, MSN Susan Finn, RN, MSN, AOCNS
More informationControlling symptoms of mesothelioma
Controlling symptoms of mesothelioma This information is an extract from the booklet Understanding mesothelioma. You may find the full booklet helpful. We can send you a free copy see page 9. Contents
More informationCATHETER for Hemodialysis
CATHETER for Hemodialysis What You Need to Know to Stay Healthy with a Catheter One treatment choice for kidney failure is hemodialysis (HD). HD removes wastes and excess fluid from your blood. Your lifeline
More informationTunnelled haemodialysis catheter
Liver, Renal & Surgery Tunnelled haemodialysis catheter Information for patients and carers This leaflet explains what a tunnelled haemodialysis catheter is and how it is put in. It also covers the risks
More informationMalignant Mesothelioma
Malignant Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)
More informationMalignant Mesothelioma
Malignant mesothelioma is a tumour originating from mesothelial cells. 85 95% of mesotheliomas are caused by asbestos exposure. It occurs much more commonly in the chest (malignant pleural mesothelioma)
More informationAdvanced Lung Cancer Treatment - Chemotherapy vs Radiotherapy
Which treatment for advanced lung cancer This information tells you about the treatments for advanced lung cancer. Chemotherapy and radiotherapy can both be used to treat advanced lung cancer. They can
More informationTransurethral Resection of Bladder Tumour (T.U.R.B.T)
Transurethral Resection of Bladder Tumour (T.U.R.B.T) Patient Information Introduction This booklet has been written to help you understand the surgery you are about to undergo. It will give you information
More informationRoyal National Throat, Nose and Ear Hospital. Functional endoscopic sinus surgery (FESS) Ear, Nose and Throat Surgery
Royal National Throat, Nose and Ear Hospital Functional endoscopic sinus surgery (FESS) Ear, Nose and Throat Surgery 31 If you need a large print, audio or translated copy of the document, please contact
More informationYTTRIUM 90 MICROSPHERES THERAPY OF LIVER TUMORS
YTTRIUM 90 MICROSPHERES THERAPY OF LIVER TUMORS The information regarding placement of Yttrium 90 microsphres for the management of liver tumors on the next several pages includes questions commonly asked
More informationIII-701 Urinary Catheterization/Bladder Irrigation Original Date: 3/1/1977 Last Review Date: 10/28/2004
III-701 Urinary Catheterization/Bladder Irrigation Original Date: 3/1/1977 Last Review Date: 10/28/2004 Purpose A. Allow for precise measurement of urine output. B. Collect a sterile urine specimen. C.
More informationMEDICINE SPECIALTIES JOB PLANNING GUIDANCE AND MODEL JOB PLAN EXAMPLE
MEDICINE SPECIALTIES JOB PLANNING GUIDANCE AND MODEL JOB PLAN EXAMPLE INTRODUCTION Since 1991 it has been a contractual requirement for all consultants to have a job plan, which is agreed and reviewed
More informationMANAGEMENT OF LIVER CIRRHOSIS
MANAGEMENT OF LIVER CIRRHOSIS Information Leaflet Your Health. Our Priority. Page 2 of 6 What is cirrhosis? Cirrhosis is a result of long-term, continuous damage to the liver and may be due to many different
More informationManagement of Catheters Infectious Diseases Working Party/Nurses Group
Management of Catheters Infectious Diseases Working Party/Nurses Group Arno Mank RN PhD, Amsterdam (NL) www.ebmt.org London 09/04/2012 Content Background Management of CVC Types of CVC Care aspect of CVC
More informationIlioinguinal dissection (removal of lymph nodes in the groin and pelvis)
Ilioinguinal dissection (removal of lymph nodes in the groin and pelvis) This sheet answers common questions about ilio-inguinal dissection. If you would like further information, or have any particular
More informationA GUIDE TO HAVING PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAM (PTC) AND BILIARY DRAIN/DILATATION/STENTING
A GUIDE TO HAVING PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAM (PTC) AND BILIARY DRAIN/DILATATION/STENTING WHAT IS PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAM (PTC) AND BILIARY DRAIN/ DILATATION/STENTING? A percutaneous
More informationDr. Peters has declared no conflicts of interest related to the content of his presentation.
Steve G. Peters, MD Dr. Peters has declared no conflicts of interest related to the content of his presentation. Disclosure No financial disclosure I serve on Advisory Committee to the AMA CPT Panel from
More informationAll About Your Peripherally Inserted Central Catheter (PICC)
All About Your Peripherally Inserted Central Catheter (PICC) General Information Intravenous (IV) therapy is the delivery of fluid directly into a vein. An intravenous catheter is a hollow tube that is
More informationINTERDISCIPLINARY CLINICAL MANUAL Policy & Procedure
INTERDISCIPLINARY CLINICAL MANUAL Policy & Procedure TITLE: Section: Source: Distribution: Chest Drainage and Chest Tube Management Respiratory/Thoracic Joy Tarasuk, CNE, Thoracic Surgery Capital Health
More informationCHAPTER V CONCLUSION AND RECOMMENDATIONS. findings are presented, implications for nursing practice and education are discussed,
CHAPTER V CONCLUSION AND RECOMMENDATIONS In this chapter, a summary of the findings and conclusion drawn from the findings are presented, implications for nursing practice and education are discussed,
More information