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.

How to Pool Medications into a Pooling Bag

By Candy Finley, RN, IgCN and Joe DiStefano, RPh

Pooling is the process of transferring the total dose of drug plus overfill into an empty IV bag ("pooling bag"). Although NuFACTOR prefers administering IVIG by spiking vials one at a time sequentially or adding drug directly into a bag of diluent (e.g., infliximab/Remicade®), there are some times when pooling is appropriate. These include lyophilized powder IVIG requiring reconstitution (e.g., Gammagard® SD and Carimmune®), HyQvia® (IG component only) and infliximab doses greater than 1000 mg. The process of pooling medications into a specially designed pooling bag is a relatively simple process. [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]

Pre-Medications Use, Side Effect Management & Intravenous Immune Globulin

By Joe DiStefano, RPh.

Intravenous immune globulin (IVIG) preparations are safe and effective treatments for a variety of medical conditions. Serious, but uncommon reactions occur, and include thromboembolic events, (e.g., pulmonary embolism, deep vein thrombosis, myocardial infarction, transient ischemic attack), renal dysfunction and acute renal failure. Mild to moderate side effects that occur during or after IVIG treatment are more common. These may include: headache, flushing, chills, myalgia, fatigue, low grade fever, changes in blood pressure and lower back pain. While many common side effects may be controlled by decreasing the IVIG infusion rate, administering physician-prescribed pre-medications can [More]

Pre-visit/Visit Preparation: Vital Tasks for a Successful Infusion

By Michelle Greer, RN, IgCN and Cindi Berry, RN, BSN.

When working in homecare, preparing to see your patient for intravenous immune globulin (IVIG) therapy can be challenging and requires a good deal of preparation. Many times, it is up to you, the registered nurse, to put together some of the information prior to seeing your patient. This information includes doctor visit notes, current orders prescribed by the doctor, specialty pharmacy orders and supplies, and knowing the type of therapy that will be administered in the home. In addition, since there are many different brands and doses of IG, you should be familiar with both of these prior to seeing your patient in the home. [More]