Policy Manual sample

MDT Home Health Care Agency, Inc. 63 c) Wipe the catheter end cap with alcohol and allow to air dry. Inject normal saline into the catheter cap if medication/solution is incompatible with heparin. d) Inject heparin into injection cap and clamp catheter if applicable. (Groshong catheters do not require heparinization and are not clamped). 16. The use of filters will be according to following guidelines: a) The appropriate size filter will be used only if indicated by drug therapy. b) Do not filter elastomeric devices since they have in-line filters and do not require additional filtering. c) Use a .22 micron filter with all Total Nutrient Admixtures (2 in 1, without lipids). Do not filter lipids when piggy-backed in the parental nutrition solution. d) Use a 1.2 micron filter with all 3 in 1 (lipids included) Total Nutrient Admixtures. e) A 5 micron filtered needle must be used in the preparation of medication from ampules. This is necessary because glass particle may remain in the solution after the top of the ampule is snapped off. f) Use 5 micron filtered needle in preparing the medication if it is to be administered to the patient directly from the syringe. If the medication is further diluted in a Mini- bag and a mixture is performed in the home setting, the 5 micron filtered needle is not necessary, however, an administration set with a .22 micron filter is required. 17. Use of administration sets/extension sets will be used per the following guidelines: a) Consider extension sets as part of the administration set and change at the time of the administration set change. b) Exceptions include extension sets attached at the time of insertion of the access device, such as the case of the PICC line. The extension connected under sterile conditions is considered part of the catheter and will only be changed due to compromised integrity. c) Do not add more than one extension set to an administration set. d) Administration sets will be changed utilizing aseptic technique immediately upon suspected contamination or when the integrity of the product has been compromised. e) Change the entire administration system (catheter, extension and administration set, and medication/solution container) if purulent drainage, thrombophlebitis, cellulites, or administration set related bacteremia are noted or strongly suspected. 18. Use the following guidelines for Intermittent or Cyclic Therapy: a) Change the administration set every 48 hours for therapies provided on an intermittent basis (e.g., anti-infective therapy) unless otherwise ordered by the physician. b) Change administration sets every 24 hours for cyclic TPN administration. 19. Use the following guidelines for Continuous Therapy: a) Change administration sets for TPN every 24 hours.