1. Chris Cunanan, RN, MSN Clinical Supervisor Dependable Home Health
Common In Home Devices
Chris Cunanan, RN, MSN
Clinical Supervisor
Dependable Home Health

2. Happens!
You will encounter a variety of devices used by patients in the home. We will discuss common problems and solutions. If you are unsure how to handle things, you can call Dependable Home Health or the home health RN taking care of the patient Dependable – (520)

3. CPAP BiPAP

4. CPAP/BiPAP
Some patients can’t tolerate the pressure and stop using the device – instruct them to use the ramping feature to help accommodate to the pressure
Dry sinuses and nasal passages – tell the patient to use a humidifier
Watch for proper fit – poor fit can cause leaks and poor functioning

5. Central Lines/PICC
PICC in place with dressing

6. Central Lines
Central Line

7. Common Problems
Infection
Displacement
Dressing disruption

8. Infection Signs/Symptoms - edema, redness, pus/
drainage, pain, heat, high
temperature
What to Do
- send patient to hospital

9. Displacement
if line becomes dislodged from the dressing and is partially out, secure it with tape to ensure no further dislodgement and call the home health RN or Dependable Home Health

10. Dressing Disruption
PICC dressings are sterile – in case of disruption, ensure that the PICC line is secure, wrap with kerlex, call the home health RN or Dependable to report the condition

11. Feeding Tubes
NG tube

12. Feeding Tubes Dobhoff tubes reside in the duodenum or first
part of the small
intestine
Dobhoff Tube

13. Feeding Tubes
PEG tube

14. Feeding Tubes
If these tubes become dislodged, displaced, or occluded, the patient must proceed to the hospital ER to have them repositioned or replaced

15. Colostomy

16. Potential Problems infection skin irritation/ breakdown
displacement of
bag/flange

17. What to do
Call home healthRN to report condition of site, call Dependable office of RN phone number unavailable
Have caregiver change bag and flange in case of displacement
In case of bowel obstruction of pain, transport to ER

18. Suprapubic Catheters Potential Problems Infection (UTI) displacement
- Call home health RN to replace catheter
- Patient to ER for tx of infection

19. Foley Catheters
Common problems – displacement, infection (UTI) Call home health RN in case of displacement, patient to ER in case of infection

20. Tube feeding pumps Used in conjunction With feeding tube
in case of pump malfunction, consult manual or
call home health RN

21. Wound Vac

22. Wound Vac

23. Common problems and solutions
Problem – leak alarm ringing Solution – ensure that all tubing in properly hooked up, ensure that reservoir is properly seated on side of pump. If this does not fix problem, turn wound vac pump off, call home health RN or Dependable to report – do not disturb dressing

24. Common problems and solutions
Problem – pump does not work Solution – ensure pump is hooked up to power cord – battery may be dead. Turn on pump and follow prompts on display to resume therapy. Pumps are made to be RN-proof, so this should be no problem.

25. Chest Tubes

26. Common problems and solutions
Problem – tube displacement Solution - reinforce dressing at insertion site, call home health RN or Dependable to report. If sutures securing tube at insertion site are loose or cut, transport patient to ER. Do not attempt to reinsert tube into chest cavity or remove tube

27. Common problems and solutions
Problem – tube occlusion Solution – transport patient to ER. Do not attempt to strip tubing to clear occlusion

28. Drains

29. Commpn problems and solutions
Problem – displacement of tubing from incision Solution – if tubing is not fully out of incision, secure with tape and call home health RN or Dependable. If tubing is completely out of incision, transport patient to ER

30. Common problems and solutions
Problem –drain bulb is full Solution – instruct caregiver to drain bulb per instructions provided by hospital. If no caregiver available, call home health RN or Dependable Problem – drain tubing not secured at insertion site Solution – secure tubing with tape

31. Wound Dressings

32. Problems and solutions
Problem – dressing displacement Solution – reinforce dressing, call home health RN or Dependable Problem – infection Solution – if infection is localized, call home health RN or Dependable. If sepsis is suspected, transport patient to ER

33. Wrapping Up
Please communicate with home health RN’s as much as possible. If you do not have a phone number, call Dependable office to obtain contact information Effective communication helps to ensure quality care for our patients

34. Questions
Thank you for your time and patience!

35. RN Phone Numbers
Neena Lopez (520) Sylvia Charles La Rue (520) Lorena Paredes (520) Gloria Felix (520) (more to come!) Supervisor Chris Cunanan (520)