חוברת הדרכה

• Home Care Guidelines

  Dear patient,

   

  The Home Cure Division and the treating staff wish you rapid recovery and success in your home care. This information leaflet is designed to help you perform IV treatment at home, as prescribed by your physician and after receiving instructions from the professional staff.

  This leaflet describes the treatment stages and helps you perform self-care at home

  

• Sterile sheet
• Infusion pole and pump (including base, charger and electric cable)
• TPN bag
• Required equipment
•  
• If the details are incompatible – do not connect to the medication and contact customer service immediately
• Ensure the TPN bag is intact and does not leak
• Examine the solution for uniformity
• Check the expiration date (always make sure to use the previous equipment you received)
• Check that your name and ID No. indicated on the TPN bag label is correct
• Examining the TPN bag
• Take proper care of the TPN bag – according to the pharmacy's instructions provided in a leaflet accompanying the equipment
• Strictly follow TPN administration time (according to physician's instructions)
• Care for the catheter and the auxiliary equipment
• Follow the treatment stages
• Maintain hygiene during treatment

Treatment Principles

Sterile gloves and mask

Infusion set + filter

Sterile gauze pads

Bottle of Alcoxidine (70% alcohol + 5% Chlorhexidine)

Saline syringe flush (NaCl 0.9%)

Heparin flush syringe

Adhesive tape / Micropore

In addition – a garbage bag

 

Sequence of actions for TPN administration

1. Preparing the TPN bag

 

Take the TPN bag out of the refrigerator 2 hours before connecting

• Wash your hands with water and soap and dry them with a clean personal towel or a paper towel
• Hang the TPN solution bag on the infusion pole
• Take the infusion set out of the package
• Close the clamp that is on the infusion set

Do not touch the exposed equipment

• Remove the cover from the tip of the appropriate tube in the TPN bag,

       remove the cover from the tip of the spike infusion set and insert the

       spiked tip into the bag by rotating with the text on the bag facing you,

       right connector, blue

2. Preparinthe BodyGuard pump

 

2.1 Attach the pump base to the infusion pole in the designated place and

      secure it by rotating the pulley located in back

2.2 Connect the cable to the charger (at the bottom part of the base)

2.3 Plug the cable into the electric socket and verify that both lights at the

      bottom of the base are on. If the lights do not turn on, verify the

      connections and verify that the pump is properly positioned in the base

2.4 Open pump door (in the bottom part of the pump) by pulling the handle

      on the right side of the pump

2.5 Hold the infusion tube with both hands and insert it from left to right into

      the designated place in the pump (under the arrows). Make sure to

      include the key that is on the infusion tube, so that the protrusions are

      facing upwards, and the key is in its designated place on the right side

2.6 Pull the infusion tube and close the door by pressing on it with both

      hands, until you hear a "click"

2.7 Open the clamp on the infusion tube

2.8 Now you must remove air from the infusion set:

1. Click the ON button

1. Ignore the message on the screen and click PRIME

1. The word AIR will appear on the screen; immediately click

OK  to confirm

Fluid is now pumped through the infusion tube, pushing the air out. If there is still air in the tube, open the pump door and close it by

pressing on it with both hands; click OK again and immediately

click PRIME to confirm

2.9 Volume: _____ml will appear on the screen; set the volume

       recommended by the treating physician using the number keys; Click

to confirm

2.10 Total time will appear on the screen; _____:_____. set the number of hours recommended by the treating physician using the number keys (check hour and minute setting, for example 10:00); click () to confirm  

2.11 Ramp up time ____:____ will appear on the screen; set the ramp up

       time recommended by the treating physician using the number keys;

 

        click () to confirm

 

2.12 Ramp down time ____:____ will appear on the screen; set the ramp

        down time recommended by the treating physician using the number

         keys; click () to confirm

2.13 Maximum rate: _____ ml/hour, calculated by the pump automatically,

        will appear on the screen; click () to confirm

The pump is ready for TPN administration

 

2.14 Stop the pump by clicking the () button followed by a long click on

 

the OFF button ()

Connecting : for TPN administration

3.1 Wash your hands with water and soap and dry them with a clean personal towel or a paper towel

3.2 Wear a mask

3.3 Spread the sterile sheet on a clean surface

3.4 Open the package of sterile pads without touching the contents, place them on the sterile sheet and pour Alcoxidine on them

3.5 Open a sterile gauze pad and place the catheter tip on it

3.6 Ensure the catheter is closed using a clamp and a plug

3.7 Open the package of gloves and put them on under sterile conditions

3.8 Hold the catheter tip with a gauze, and using your other hand

      Disinfect the catheter plug with a gauze pad soaked in

      Alcoxidine – threetimes, using a new pad each time

3.9 Hold the saline syringe with gauze

3.10 Remove the cover from the saline syringe under sterile conditions, and ensure there is

        no air in the syringe

3.11 Connect the syringe tip to the catheter plug (by pressing and rotating

3.13 Slowly inject the syringe contents

3.14 Close the clamp

3.15 Disconnect the syringe from the catheter plug by rotating, and discard the syringe in

         the garbage bag

3.16 Remove the cover from the infusion set tip and connect the infusion set to the catheter

       plug (by pressing and rotating)

3.17 Start the pump by clicking the ON  button

3.18 Volume: _____:_____ml will appear on the screen; click () to confirm

3.19 Total time will appear_____:_____ on the screen; click () to confirm

3.20 Ramp up time will appear on the screen; set the ramp up time recommended by the

        treating physician using the number keys; click () to confirm

3.21 Ramp down _____:_____ time will appear on the screen; click () to confirm

3.22 Maximum rate: ml/hour, click () to confirm

3.23 Open the clamps that are on the catheter and on the infusion tube

3.24 Remove the gloves

You are connected to the TPN program

End TPN administration and disconnect the TPN bag

Required equipment

3. A sterile sheet

4.Sterile gloves and mask

5. Sterile gauze pads
6. Bottle of Alcoxidine (70% alcohol + 0.5% Chlorhexidine)
7. A flush syringe (NaCl 0.9%) Saline
8. A heparin flush syringe – by prescription
9. Adhesive tape / Micropore, and in addition garbage bag

Do not touch the exposed equipment

Before disconnecting the TPN bag close the clamp that is on the catheter and the

clamp that is on the infusion tube and discontinue pump operation by clicking the

 (

() button followed by a long click on the OFF button ()

• Wash your hands with water and soap and dry them with a clean personal towel
• Wear a mask
• Spread the sterile sheet on a clean surface
• Open the package of sterile pads without touching the contents, place them on the sterile sheet and pour Alcoxidine on them
• Open a sterile gauze pad and place it under the connection site between the catheter and the infusion set
• Open the package of gloves
• Put the gloves on under sterile conditions
• Hold the catheter tip with a sterile gauze and disinfect the connection site between the infusion tube and the catheter plug with a gauze pad soaked in Alcoxidine
• Disconnect the infusion tube from the catheter (by pressing and rotating)
• Disinfect the catheter plug with a gauze pad soaked in Alcoxidine – threetimes, using a new pad each time
• Remove the cover from the saline syringe under sterile conditions; ensure there is no air in the syringe
• Connect the syringe tip to the catheter plug (by pressing and rotating
• Open the clamp on the catheter
• Slowly inject the syringe contents and close the clamp that is on the catheter
• Disconnect the syringe from the catheter plug by rotating and discard the syringe in the waste basket

If there is indication for heparin administration

• Ensure the syringe and plug are intact. Remove the cover from the heparin syringe under sterile Connect the syringe tip to the catheter plug (by pressing and rotating)

• Open the clamp that is on the catheter
• Slowly inject the syringe contents and close the clamp that is on the catheter
• Disconnect the syringe from the catheter plug by rotating and discard the syringe in the waste basket

4.21 Remove the gloves

You have completed TPN administration

Replacing the catheter plug

The catheter plug should be replaced once a week, or according to the manufacturer's instructions

Required equipment

• A sterile sheet + sterile gloves and mask
• A new sterile plug
• Sterile gauze pads
• Garbage bag
• Bottle of Alcoxidine (70% alcohol + 5% Chlorhexidine)

Sequence of actions

1. Wash your hands with water and soap and dry them with a clean personal towel
2. Wear a mask (in accordance with the policy)
3. Spread the sterile sheet
4. Open the package of sterile pads and the plug package without touching the contents; place them on the sterile sheet and pour Alcoxidine on the pads
5. Close the clamp that is on the catheter (if applicable)
6. Open the package of gloves
7. Put the gloves on under sterile conditions
8. Place a sterile pad under the plug that is connected to the catheter
9. Disinfect the connection site between the plug and the catheter using gauze pad soaked in Alcoxidine – three times, each time using a new pad.
10. Remove the current plug by rotating
11. Remove the seal from the new plug
12. Attach the plug by rotating

 If required – connect to the TPN program

 

 

Changing the catheter dressing

Once or twice a week, or whenever the dressing is dirty or wet, you must change the catheter dressing

 

Required equipment

 

• A sterile sheet + sterile gloves and mask
• Fenestrated gauze/Tegaderm
• Sterile gauze pads
• Garbage bag
• Bottle of Alcoxidine (70% alcohol + 5% chlorhexidine)
• Adhesive tape / Micropore + label

Sequence of actions

 

1. Wash your hands with water and soap and dry them with a clean personal towel

Press on the catheter exit site with your finger – to prevent catheter movement

2. Remove the adhesive tape and the old dressing around the catheter, from the bottom upwards
3. Check the catheter insertion area – redness , irritation, swelling, discharge
4. Wash your hands with water and soap again and dry them with a clean personal towel
5. Spread the sterile sheet on a clean surface
6. Open the package of sterile pads without touching the contents, place them on the sterile sheet and pour Alcoxidine on the pads
7. Put the gloves on under sterile conditions
8. Clean the skin around the catheter insertion area using a gauze pad soaked in Alcoxidine using circular movements from the center outwards – three times, each time using a new pad
9. Cover with transparent Tegaderm or Hypodress
10. Attach a label to the dressing, indicating the dressing change date
11. Attach the catheter to the dressing or to the skin using adhesive tape /Micropore

It is important to keep the dressing dry and clean