A Caregiver’s Guide to: IV Therapy at Home (Part 1 of 3)

A Patient’s Story

It has been 2 months since Mr Ng last saw his home or slept in the warmth of his bed. Sadly, Mr Ng is not on a holiday, he has been hospitalised for endocarditis, a condition that requires long term IV antibiotics. Mr Ng is just one of the many patients who extend their stay in hospital due to intravenous (IV) or intramuscular (IM) medications.

A Widespread Need

As hospital bed crunches become increasingly common across all developed cities, waiting out a course of IV antibiotics while in hospital may not be a viable option for everyone. Furthermore, a lengthened stay in hospital can potentially lead to hospital-acquired infections, especially when one’s immunity is low. In fact, a local report found that more than 10% of patients in Singapore hospitals catch an infection while hospitalised. 

Bringing ‘the Hospital’ to Home

These are some of the reasons why medical home care has risen in importance in Singapore. In contrast to non-medical home care, which includes home personal care and support for activities of daily living, medical home care supports patients with complex medical needs, including oncology, infectious disease, haematology, gynaecology and neurology.

A common sight in the USA and the UK, such medical home care is often led by skilled registered nurses. These nurses may come from medical specialities such as oncology, infectious disease, and haematology. In some parts of the UK, it is even commonplace to have chemotherapy administered at home.

Home visits by nurses help bring care closer to patients

When is IV Therapy Used?

Specific to oncology, patients may require additional nutrition to boost their recovery potential. This comes in the form of IV total parenteral nutrition (IV TPN). The aim of TPN is to prevent malnutrition. It is a liquid nutrition which is administered into the bloodstream, containing life-sustaining carbohydrates, proteins, fats, vitamins, minerals and electrolytes. This is especially important for patients who have difficulties taking food through the mouth and usual digestive system. In such circumstances, IV TPN is typically infused on a daily basis, for anywhere between one to four weeks by skilled nurses.

For infectious diseases, patients typically require IV antibiotics daily for two weeks or more. Haematology patients may require IM injections to treat certain clotting factors, and gynaecology patients may require IM progesterone injections. Such patients are often fit for discharge, but may be warded for a few more days for treatments that can be easily given at home.  

Because IV therapy is a specialized skill, it is of utmost importance to ensure the visiting nurses have the right level of qualification and skill. At Jaga-Me, IV therapy services are provided only by experienced and rigorously trained registered nurses, each having well-over 5 years of hospital experience. On top of that:

  • our nurses undergo hands-on competency tests for IV administration, and 
  • standard Operating Processes are in place with staff adherence documented, similar to the practice in local hospitals.

As a registered nurse who has worked in an acute hospital setting for 12 years, I personally understand this gap of receiving IV treatment at home. As part of the Jaga-Me clinical team,  we have been actively supporting patients and nurses in the community, in order that IV therapy be rendered safely. Should you require such services, please view this link for more information: https://jaga.sg/iv  

Do look out for our next edition in this series, where we will discuss the care for central venous devices that patients are discharged home with!

By Jasber Kaur, Registered Nurse (Singapore Nursing Board), Clinical Educator

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