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A daily course of chemotherapy no longer automatically means an overnight hospital stay for many pediatric patients. Through an initiative launched earlier this year by Children's Hospital Boston and the Dana-Farber Cancer Institute's Jimmy Fund Clinic, eligible patients have the option of receiving
intravenous fluids from a small pump carried in an easy-to-wear backpack.
The program, called the home hydration service, enables young patients to spend more time outside the hospital environment, sleeping either at home or a home-away-from-home facility, such as the Ronald McDonald House. Although it was conceived as a way to free up inpatient beds in Children's oncology unit, the
service has become popular with patients and their families for the respite it provides from hospital routines and schedules. ’ÄúWhen your child is going through the day-to-day challenges of receiving chemotherapy, any bit of normalcy you can provide is a bonus," says a parent from Greenfield, whose daughter has used the pump during her treatment.
Hydration is a standard complement to chemotherapy, says Kathleen Houlahan, MS, RN, stem cell transplantation nurse program manager at Children's. Following a chemotherapy
infusion, patients receive a continuous supply of fluids by
intravenous drip. Traditionally, this has meant being tethered
to an IV pole that holds the fluid bags. In the past, Dana-Farber outpatients who completed their chemotherapy infusions late in the day were admitted to Children's in order to receive hydration overnight. Now, the pump and backpack give many outpatients at the clinic, as well as inpatients at Children's, the ability to go
home for the night. Eligible patients are referred to the program by their physician or nurse practitioner.
Families who opt for home hydration receive the pump (roughly the size of a pair of binoculars), a backpack and fluid bags during their clinic visit. Parents are taught how to replace empty bags with full ones’Äîa simple process of disconnecting and
reattaching plastic tubing’Äîand when to call a doctor or the pump manufacturer if problems arise. The pumps have an
excellent performance record and fees for their use are billed directly to insurers.
The pumps have proved attractive to patients and parents.
Of 19 eligible patients who have been offered the device so far,
15 have opted in, according to Houlahan. Many families have
recommended it to others. Although home hydration has been used in adult cancer treatment for many years, it's relatively new in pediatric oncology, says Susanne Conley, RN, MSN, CPON, nurse program manager in the Jimmy Fund Clinic. ’ÄúThis system is so easy to use that parents have no trouble with it," Conley says. ’ÄúBecause it enables them to bring their children home at night, where everyone is more comfortable, it lessens the burden on the family. It's been a useful way to increase the quality of care."
More information: danafarberchildrens.org.
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