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Module 1: Introduction to Home and Specialty Infusion Practice

Module I of VII, 4th Edition (revised in 2013)

module 1

The post-test for this continuing education activity will expire on October 23, 2016 11:59 p.m.

3 contact hours of Continuing Education (CE) credit for pharmacists, nurses and dietitians will be awarded when a score of 70% or higher is achieved in the on-line post-test for this module.

Authors: Jeannie Counce, Nancy Kramer, RN, BSN, CRNI®, William Noyes, Kendall (Ken) Van Pool

LEARNING OBJECTIVES:

Upon completion of this module the participant will be able to:

  1. Describe the key issues that have influenced the development of the home infusion therapy industry, including laws, regulations, reimbursement issues, and accreditation
  2. Describe the most common business structures for home infusion therapy providers
  3. Describe the complexity and significance of reimbursement issues in home infusion practice
  4. Describe and discuss the responsibilities of the home infusion team
  5. Identify key clinician responsibilities unique to home infusion therapy
  6. Identify common IV access and infusion devices used for home infusion therapy
  7. Describe the future practice considerations that are shaping the home and specialty infusion industry

Click here to view the table of contents.


Module 2: Overview of Home and Specialty Infusion Reimbursement

Module II of VII, 4th Edition (revised in 2015)

module 2

The post-test for this continuing education activity will expire on January 27, 2018 at 11:59 p.m.

3 contact hours of Continuing Education (CE) credit for pharmacists, nurses and dietitians will be awarded when a score of 70% or higher is achieved in the on-line post-test for this module.

Author: David M. Franklin, MSA

LEARNING OBJECTIVES:

Upon completion of this module the participant will be able to:

  1. Discuss key concepts related to the health care revenue cycle and home infusion reimbursement
  2. Identify differences between eligibility requirements and home infusion coverage for major payer sources, including Medicare, Medicaid, and commercial insurance carriers
  3. Weigh the financial and operational risks and benefits for home infusion providers that contract with managed care organizations and other commercial insurance carriers to provide patient care
  4. Differentiate home infusion coverage under Medicare Parts A, B, D, and C
  5. Differentiate the various coding systems that apply to billing for home infusion products and services in the private and public sectors
  6. Identify methods for collecting payments from customers
  7. Calculate reimbursement productivity indicators
  8. Be aware of challenges specifically related to Medicare reimbursement for home infusion therapy
  9. Understand legislation relevant to home care that is intended to prevent fraud and abuse

Click here to view the table of contents.


Module 3: Overview of Infusion Devices, Vascular Access Devices and Ancillary Supplies

Module III of VII, 3rd Edition (revised in 2012)

module 3

The post-test for this continuing education activity will expire on September 26, 2015 at 11:59 p.m.

3 contact hours of Continuing Pharmacy Education (CPE) credit will be awarded when a score of 70% or higher is achieved in the on-line post-test for this module.

Original Authors: Debbie Cain, RN, CRNI®  and  H. Lynn Kelley, RPh

3rd Edition Reviewers: Kevin Ross, RN, BSN, and Nancy Kramer, RN, BSN, CRNI®

LEARNING OBJECTIVES:

Upon completion of this module the participant will be able to:

  1. Describe the history of vascular access device design and utilization in the United States.
  2. List the considerations when selecting an appropriate access device for the prescribed home infusion therapy. Explain assessment and treatment of VAD occlusions in the home infusion setting.
  3. List the clinical definitions of VAD-related infections.
  4. Identify the selection criteria involved in choosing appropriate infusion devices.
  5. Describe the standard ancillary supplies used with each major type of home infusion therapy.
  6. Describe the major components of a comprehensive patient and staff education plan.
  7. List types of enteral delivery devices.

Click here to view the table of contents.


Module 4: Nutrition Therapies: Parenteral Nutrition, Enteral Nutrition, and Hydration

Module IV of VII, 4th Edition (revised in 2015)

module 4

The post-test for this continuing education activity will expire on September 1, 2018 at 11:59 p.m.

5 contact hours of Continuing Pharmacy Education (CPE) credit will be awarded when a score of 70% or higher is achieved in the on-line post-test for this module.

Author: Carol Rollins, MS, RD, PharmD, CNSC, BCNSP, FASPEN, FASHP

LEARNING OBJECTIVES:

Upon completion of this module the participant will be able to:

  1. Enumerate the indications for which a patient may be prescribed home nutrition and/or hydration therapy
  2. Assess the functional capabilities of a patient referred for home nutrition support and their appropriateness for this therapy
  3. Name three (of the six) commonly used equations for estimating resting energy expenditure
  4. Analyze the various central venous access devices (CVADs) available for PN administration and denote which situations lend themselves to which device
  5. Describe the various feeding tubes available for EN administration and denote the major structural difference between them
  6. List three strategies home care clinicians can use to address the inherent stability issues surrounding total nutrient admixtures
  7. Identify issues related to the sterile compounding of PN that can contribute to short stability and sterility
  8. List three commonly prescribed medications that can safely be admixed with many home PN
  9. Describe the clinical factors that should be considered when determining the infusion time for a cyclic PN regimen
  10. Discern the substantive difference between the two types of enteral formulas
  11. Understand the risks of initiating nutrition support therapy in the home
  12. Recognize the necessary elements in a care plan for patients needing home nutritional support

Click here to view the table of contents.


Module 5: Introduction to Home Infusion Therapies: Antibiotics, Chemotherapy and Miscellaneous Therapies

Module V of VII, 3rd Edition (revised in 2012)

module 5

The post-test for this continuing education activity will expire on July 3, 2015 at 11:59 p.m.

5 contact hours of Continuing Pharmacy Education (CPE) credit will be awarded when a score of 70% or higher is achieved in the on-line post-test for this module.

3rd Edition Authors:   Marc Stranz, PharmD and Kevn McNamara, PharmD

LEARNING OBJECTIVES:

Upon completion of this module the participant will be able to:

  1. Understand the importance of assessing a patient’s age, weight, organ function,
    creatinine clearance, and mental status in order to ensure that every prescribed infusion modality is safe and appropriate for home.
  2. Develop a patient care plan that is thorough, concise, and includes patient goals as well as potential complications of therapy.
  3. Identify adverse events that may be associated with each of these parenteral modalities and the steps that should follow the identification of an adverse event.
  4. Formulate an education plan for new patient admissions that includes indication
    and use of the prescribed modality, medical devices used to deliver the therapy,
    side effects, monitoring parameters, and the importance of compliance.
  5. Describe appropriate laboratory values and ranges to be assessed prior to  admission and during home anti-infective therapy and understand the importance
    of trending such laboratory values.
  6. Recognize the pathogens associated with the most common infections treated with
    home infusion therapy and be able to recommend appropriate anti-infective regimens for home therapy.
  7. Discuss appropriate techniques for the sterile preparation of anti-infective nfusions
    to be administered in the home.
  8. Identify common anti-infective and chemotherapy infusion therapies that may be drescribed for home use, their clinical applicability, and general monitoring parameters.
  9. Identify appropriate techniques for the sterile preparation of chemotherapy infusions to be administered in the home.
  10. Describe the adverse events common to cytotoxic agents used in the home and be
    familiar with common palliative therapies prescribed along with home chemotherapy to manage them.
  11. Discuss use of the World Health Organization (WHO) algorithm for pain management and basic concepts of treating pain, including addiction, tolerance, dependence, withdrawal, and patient-controlled analgesia.
  12. List side effects commonly seen with pain control regimens and are able to recommend both pharmacologic and nonpharmacologic regimens to treat them.
  13. Discuss the principles of dosage conversion with pain management and how oral, intramuscular, intravenous, intrathecal, and epidural doses relate to each other in equivalency.
  14. Describe common miscellaneous infusion therapies that may be prescribed for home use, their clinical applicability, and general monitoring parameters.

Click here to view the table of contents.


Module 6: Compounded Sterile Preparations in Home Infusion

Module VI of VII, 4th Edition (revised in 2015)

module 6

The post-test for this continuing education activity will expire on June 1, 2018 at 11:59 p.m.

4 contact hours of Continuing Pharmacy Education (CPE) credit will be awarded when a score of 70% or higher is achieved in the on-line post-test for this module.

4th Edition Author:  Don Filibeck, PharmD, MBA, CSP, FASHP

LEARNING OBJECTIVES:

Upon completion of this module the participant will be able to:

  1. Classify compounded sterile preparations (CSPs) according to the risk levels established by the United States Pharmacopeia (USP).
  2. Describe the differences in the way an operator works in a vertical flow versus a horizontal flow hood.
  3. Discuss what is involved in certification of a primary engineering control (PEC) (i.e. laminar airflow workbench (LAFW)) and know the criteria that must be met.
  4. Explain basic concepts for designing a controlled area for aseptic compounding.
  5. Describe how to correctly scrub and gown for the controlled area.
  6. Identify correct procedures for the operation and sanitization of a laminar airflow workbench.
  7. Identify important issues related to the training and testing of personnel involved in product preparation of CSPs.
  8. Describe the basic concepts of aseptic technique and product manipulation.
  9. List the components of an environmental monitoring plan.
  10. Explain the basic concepts of sterility testing.
  11. Identify appropriate housekeeping procedures for the buffer area and anteroom area.
  12. Compare and contrast techniques used for pyrogen and endotoxin testing.

Click here to view the table of contents.


Module 7: Overview of Financial and Operational Issues in Home Infusion Therapy

Module VII of VII, 4th Edition (revised in 2014)

module 7

The post-test for this continuing education activity will expire on June 13, 2017 at 11:59 p.m.

5 contact hours of Continuing Education (CE) credit for pharmacists, nurses and dietitians will be awarded when a score of 70% or higher is achieved in the on-line post-test for this module.

4th Edition Authors: L. Rad Dillon, RPh, CME/OE; Barbara Petroff, MS, RPh, FASHP; and Nancy Kramer, RN, BSN, CRNI®

LEARNING OBJECTIVES:

Upon completion of this module the participant will be able to:

  1. Describe the types and functions of staff found in home and specialty infusion organizations.
  2. Identify and describe critical points in the patient referral process.
  3. Describe key concepts related to purchasing and inventory management.
  4. Identify key financial terms and concepts used by home and specialty infusion organizations.
  5. Describe the advantages and disadvantages of various delivery methods.
  6. Describe important aspects of risk management encountered by home infusion organizations.
  7. List the fundamental components of a "quality tool kit" suitable for use by a home and specialty infusion organization.
  8. Explain how to monitor and improve workplace efficiency.
  9. Define the role of clinical and operational benchmarking in performance improvement.
  10. Describe the federal regulatory requirements that apply to the home and specialty infusion provider business regarding the protection of the environment.
  11. Describe the federal regulatory requirements that apply to the home and specialty infusion provider business regarding worker safety.
  12. List the steps required by OSHA regulations to protect workers from occupational exposure to blood or other potentially infectious materials.
  13. Compare and contrast hazardous drugs and non-hazardous drugs with regards to the federal regulations governing handling and disposal throughout their life cycle.
  14. Describe regulatory-compliant methods of medical waste management that balance protection of the worker and environment with disposal cost considerations.
  15. List the steps a home infusion provider must take to implement OSHA's respiratory protection standard for employees at risk for exposure to airborne pathogens and aerosolized hazardous drug particles.
  16. Describe the regulatory record keeping requirements related to employee safety and environmental protection.

Click here to view the table of contents.