Is it safe for patients to disconnect their own continous chemotherapy pump at home?
Does anyone have policy/precedure? If so what evidence did you base it on?
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Depends on the patient, family/cg support and what chemo med is infusing. We have had pt's diconnect chemo at home without any problems. I think you have to evaluate each pt individually to make that decision. We had a patient that lived in a different state that no home health nursing in the area would see because she was receiving chemo. She was receiving a 7 day infusion of cytoxan, adriamycin and dacarbazine. She would be seen here by oncologist and then orders would be sent to us. We would mix med and I would meet her in the clinic and connect her chemo. Her husband would disconnect her chemo when it was complete-we did this for 6 chemo cycles without any incidence. We also try to make sure that all patients can disconnect and flush their lines no matter what med they are receiving in the event of some type of emergency so their lines don't clot off before a nurse can get to them. However there are pt's and families that I wouldn't want near a simple hydration much less a chemo so I think you have to evaluate each pt.
Besides evaluating patient/family, I would also want to know the home disposal requirements for hazardous waste. At least for biohazardous waste and sharps, they are very different for residential vs. hospital/facility. Haven't looked into this for hazardous drug disposal, but it would be state regulated, I'm guessing. Do you give them a cytotoxic disposal container to go home with them and bring back?
I would also be concerned that caregiver use the same precautions that you do in disconnecting. It usually takes a few practice sessions before non-health care folks are competent at IV therapy . . . and then there is the safe handling on top of that. Safety would be of paramount concern.
Yes-we always provide a chemotheapy biohazard container for the disposal of empy chemo bags/syringes/tubing etc. At the end of the therapy or when the container is full we either arrange for one of your drivers to pick it up or the patient brings it back to the clinic and we pick it up there. You may also want to look into what your state's regs are-some states allow for chemo waste to be disposed of in the regular trash (I know shocking isn't it). We also provide patients with a chemo spill kit that must be available at all times. Patients/caregivers are instructed in the use of the kit in the event of a leak/spill.