Policy Manual sample

MDT Home Health Care Agency, Inc. l) The nurse may administer long-acting Prolixin by injection after the physician has given the first two injections. Medical supervision is required every two months. Prolixin is contraindicated for patients who are users of alcohol, addictive drugs and sedatives. The nurse is to notify the physician immediately if any of these conditions exist and Prolixin is to be discontinued. m) The physician must give the first two injections of gold compounds, the nurse may give subsequent doses. The physician is monitor the patient every three weeks. After the patient has received the medication for six months and has no untoward effects, medical supervision may be every two months. n) The nurse may administer, teach or supervise the administration of injectable heparin if the patient has already been heparinized and the patient is monitored by the physician every fourteen (14) days, Either sodium heparin or calcium may be used. Length of treatment is determined by the patient's physician. The nurse may supervise the patient's administration of heparin through the Hickman/Broviac, Uldall or Tankoff catheters following an approved protocol for the patient. Prior blood work is necessary before administering the drug. The nurse is to observe the patient for bleeding and monitor other drugs, including alcohol. The patient must be monitored by the physician every two weeks until condition is stable then once a month. o) Research and study findings indicate the possibility that Imferon may be carcinogenic in humans. Also serious skin breakdowns continue to be reported. It can also cause severe anaphylactic reactions. Imferon should be used only very sparingly and only when the patient cannot be managed by any other drug. When administered it will be administered using the "Z" track method. A test dose is to be administered by the attending physician. Appropriate lab studies are to be done. p) Prefilled Syringes - Insulin syringes may be prefilled but the interval between visits to fill syringes is not to exceed one week. q) Orders for intravenous administration of isotonic solutions will be carried out. r) There are to be no more than three (3) attempts at venipuncture by the R.N. Assistance is to be obtained at this point. s) Requests for additives other than vitamins are to have appropriate laboratory tests to substantiate orders. t) All supplies and equipment can be supplied by family and/or coordinated by the agency. u) Drugs NOT administered are those used for the purpose of desensitization and those which are well known to cause severe reactions. v) The following are NOT given: - Allergenic preparations - Curare or any of its derivatives - ACTH and its derivatives - Crude liver extract The following are reviewed prior to administering the first dose in the home: Home Health Agency - - Skilled Professional Services D-64