Residency
Home Infusion Services Rotation
Preceptors:
Marci Wall, PharmD, Pharmacy Supervisor
Jay Lewandowski, RPh, Pharmacy Manager
Site Description:
The University Home Infusion Pharmacy "UHIP" is a part of the University HealthCare system. UHIP is an alternate site infusion pharmacy primarily providing pharmaceuticals and supplies to patients in the home setting, consultation and coordination of services. UHIP is licensed as a pharmacy by the Utah State Board of Pharmacy and accredited by The Joint Commission meeting Home Care standards. UHIP provides pharmacy services throughout the state of Utah.
UHIP embraces the following MISSION:
- Quality
- Safety
- Cost Effectiveness
- Leadership/Advancing Home Infusion Pharmacy Practice
UHIP has the following VISION:
- We Believe each patients IV needs can be safety provided I the comfort and safety of one's home.
- Our Commitment is to provide health care professionals, patients and caregivers with the knowledge and skills necessary for home I.V. therapy.
- Our Staff is committed to providing education, support, care planning, communication, and coordination with the patient, family, and health care team.
UHIP is staffed and operated 24 hours a day, 7 days a week, and 365 days a year, by professionally trained and licensed nurses, pharmacists, and pharmacy technicians. Additionally, reimbursement staff, delivery and general office staff assist to complete daily activities. Nursing Services are provided by qualified Medicare Certified Home Health care agencies and hospice agencies.
Guided by its MISSION and VISION, UHIP provides a wide range of infusion services to patients within the state of Utah with therapies from anti-infectives, anti-fungals, chemotherapy, hydration, injectables, IGIV, Total parenteral Nutrition, Inotropic, Chelation, Factor products, Pain management and cath care to name a few. UHIP also provides consultation and coordination services.
UHIP referrals may be received directly from the community from Home Health or Hospice, Physician's offices, or Emergency Departments. Referrals are also received from the University of Utah Health Care system. Freedom of choice is always provided to the patient. Within the University of Utah Health Care hospitals, UHIP has infusion specialists who assist with care resource/financial resource assessment and coordination of the infusion plan of care. UHIP works with the Huntsman Cancer Institute and has the State of Utah Hemophilia contract. A Case Management model is followed and services are provided to all the Utah Medicaid hemophilia patients.
UHIP contracts with most of the major insurance providers in the market including two Medicaid HMO plans. UHIP makes every attempt to work with non-contracted payors on a case by case basis placing patients' financial responsibility and their interest first and foremost in decision process.
University Home Infusion Pharmacy provides the highest level of service, quality and patient focused care to all patients, health care providers, and members of the patient's health care team.
Rotation Description:
The successful resident will work alongside our clinical team of nurses and pharmacists. The resident will participate in all aspects of pharmacy services offered from the Home Infusion Service from hospital discharge to home to completion of therapy. This will include intake qualification, assessment and re-assessment, monitoring, reviewing labs, consulting and providing education to nurses and patients. The resident will make recommendations on therapy dosage changes or additional therapies as observed by patient response, lab values or other situation requiring intervention from our clinical staff to ensure the best possible outcome for the patient.
The resident will round outside of our pharmacy with our two Infusion Coordinators which are located at the hospital. Experience gained here is focused on appropriate candidates for home infusion, appropriate orders for patients being discharged with an IV access in place.
The resident will gain experience is the different infusion drug delivery methods and appropriate selection based on financial considerations, patient demographics and clinical needs. These would include IV push, gravity, elastomeric infusions and our ambulatory infusion pumps.
RLS Goals:
R1.3 Prepare and dispense medications following existing standards of practice and the organization's policies and procedures.
R1.4 Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use system
R2.4 Collect and analyze patient information.
R2.11 Communicate ongoing patient information.
E7.2 Communicate effectively
Activities Evaluated:
| Rotation Activity | RLS Goal | Teaching Method |
| Weekly Rounding with Infusion Coordinator (Appropriate patients and therapy for home infusion) | E7.2, R2.4, R2.11 | I,C,M,F |
| Daily Clinical Coordination of Services (Communication with healthcare staff both internal and external. Appropriate selection of drug delivery system, provide patient education, review/communication of lab values, monitoring and documenting services) The resident will also provide formal presentations of at least 3 patients in 2 therapy groups. | E7.2, R1.3, R1.4, R2.4, R2.11 | I,C,M,F |
| Daily entering, preparation, and dispensing of IV medications and supplies. | E7.2, R1.3, R2.4, R2.11 | I,C,M,F |
| The resident will understand of types of IV access and appropriate care of IV access. | E7.2, R1.3, R1.4, R2.4, R2.11 | I,C,F |
| The resident will understand ambulatory infusion pumps. | R1.3,R1.4,R2.4,R2.11 | I,C,F |
| Overview of USP 797 / Clean Room requirements with the infusion room supervisor. | R1.3 | I,C,F |
| Introduction to Medicaid Hemophilia Program thru rounding with our Hemophilia Coordinator, dispensing medications, attend quarterly review at Medicaid (date specific). | E7.2, R1.3, R1.4, R2.4, R2.11 | I,C,F |
Readings and Preparatory Work:
Nursing handbook related to types of central venous access.
Project/Presentation Description:
Present three patients in at least two therapy groups (antibiotic, TPN, hemophilia). Discuss to clinical staff appropriate management of a specific disease requiring IV therapy or discuss a group of IV medications, or specific regimen.
Typical Daily/Weekly/Monthly Activities:
Review workload of scheduled deliveries, obtain orders, labs, contact patient, healthcare providers to review response to therapy and progress to goals, recommend dosage changes as appropriate, select proper deliver device or IV therapy (eclipse, gravity, infusion pump). Enter and dispense work orders for compounding by pharmacy technicians and select proper supplies to be used for administration.
Evaluation:
The resident will receive regular feedback from the staff of Home Infusion. A short midpoint evaluation will be posted in ResiTrak and a final summative evaluation will be done following the final "sit-down" evaluation on the last day of rotation.
