Infusion
Nursing Notes
By Nufactor

Infusion Nursing Notes by Nufactor provides education, resources and support to promote successful patient therapy within the infusion nursing community.

IV Supply Shortages

By Derrek Blake RN, IgCN - Co Author: Amy Ehlers BS, PharmD, BCPS.

Who knew that Hurricane Maria could lead to such a dramatic shortage of medical products in the United States that all hospitals and pharmacies rely on? Puerto Rico was one of the hardest hit areas by Maria and damaged American manufacturing hubs for medical products. Roughly 43% of the United States IV fluids, IV bags and minibags are manufactured and produced in Puerto Rico. [More]

Psycho-social Considerations of Patients Receiving Home Infusion of Immune Globulin

By Jean McCaslin, RN, IgCN.

In every aspect of medical care, a patient-centric approach is invaluable. Each healthcare discipline must take into consideration each patient’s holistic need when undertaking a plan of care; psycho-social needs are particularly critical. Patients receiving immune globulin (IG) oftentimes are newly diagnosed with a chronic or debilitating disorder and experience adverse feelings. Care partners or family members may be equally affected by the diagnosis and prescribed treatment modalities. [More]

Administration, Common Side Effects and Dosing of INFLIXIMAB (REMICADE®)

By Candy Finley, RN, IgCN.

Infliximab is an intravenously administered genetically engineered monoclonal antibody that neutralizes inflammation caused by a protein called tumor necrosis factor alpha (TNFα) by binding to the soluble and transmembrane forms of TNFα with its receptors. Elevated concentrations of TNFα have been found in the tissues and fluids of patients with the Food and Drug Administration (FDA)-approved diagnoses. Infliximab controls the activity of several inflammatory chemicals. It is FDA-approved to treat rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, plaque psoriasis, psoriatic arthritis and ulcerative colitis. Once established on treatment, symptoms should start to improve over a period of two to twelve weeks. [More]

Home Infusion of Immune Globulin: Navigating the Challenges

By Jean McCaslin, RN, IgCN.

Home health care continues to be the fastest growing segment of the health care industry. Many patients prefer the convenience and comfort of receiving care in the home. While the infusion of immune globulin (IG) requires specialty knowledge and precaution, the home infusion environment itself requires thoughtful consideration and accommodation. [More]

Anaphylaxis Review & Epinephrine Auto-Injectors and Vials

By Joe DiStefano, RPh.

Anaphylaxis is a severe systemic allergic reaction resulting from exposure to allergens that is rapid in onset and can result in a life-threatening emergency. Severe hypersensitivity reactions and anaphylaxis to immune globulin (IG) are uncommon. Patients with low serum IgA with anti-IgA antibodies are at greater risk.

Anaphylaxis signs usually occur within minutes of exposure to an allergen; sometimes it can occur [More]

Lyophilized Powder IVIG: Dilution, Reconstitution, and Pooling

By Derrek Blake, RN, IgCN, and Joe DiStefano, RPh.

Intravenous immune globulin (IVIG) is available as either a liquid or lyophilized (freeze-dried) powder. Initially only powder products were available, requiring reconstitution before administration. Over time, manufacturers changed their manufacturing process to achieve stability of the IgG molecules in a suspended or liquid state. By doing so, the task of reconstitution has been eliminated, making the powder products relatively obsolete. Depending on the brand, IVIG liquid is available in 5% and 10% concentrations. Depending on the brand, IVIG powder is reconstituted to yield a concentration between 3% and 12%. [More]

Part Two of Two. Central Catheters used for IVIG: Care and Complications of PICC lines and Port-a-Caths

By Jean McCaslin, RN, IgCN.

In our last blog, the types of central catheters typically used for the infusion of IVIG were discussed. Also reviewed, was the assessment of these ports as it relates to IVIG therapy. In this blog, the care of central lines (herein called VADs; Vascular Access Devices) and potential complications will be covered. This discussion will be limited to the intermittent use of VADs for IVIG therapy being given between 1-5 days monthly. For more detailed information regarding continuous VAD use, or the administration of other medications, please refer to the INS standards published on their website. [More]

Part One of Two. Types of Central Catheters used for IVIG, Assessment, Care, and Complications

By Derrek Blake, RN, IgCN.

It is essential all nurses know how to properly evaluate, access, and provide proficient central line care. NuFactor provides IVIG therapy to patients in the home and while the majority of these patients receive IVIG via a peripheral IV, there are some patients who receive IVIG via a PICC line or an implanted port (such as Port-a-Cath brand). We as nurses must be competent and comfortable providing care to these patients with a central catheter. While central catheters can be slightly confusing to a nurse who may only see one central catheter a year, this post will help you understand the differences between central catheters used and how to provide the proper care for each. [More]