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Council flags barriers to IV cardiac drips in community hospice care; Calvary and Connecticut Hospice accept short-term infusions
Summary
Members described cases where patients on dobutamine drips posed discharge challenges; agencies lack access to certain IV infusions in the community, and council plans to invite a speaker on diversion and IV medication barriers.
Council members recounted recent cases where patients on cardiac inotropic drips such as dobutamine presented barriers to discharge from hospitals into hospice or other community settings because some home and community providers lack access to IV infusions.
One council member said Calvary and Connecticut Hospice will accept patients on short-term dobutamine drips if the plan is to wean the medication and not maintain it long term. The member described a recent case in which a cardiac patient and family wanted discharge while continuing the drip; discharge planning required collaboration between hospice providers and cardiology to determine whether the drip could safely be continued in the community.
The discussion noted that these infusion issues are broader than narcotics diversion concerns and include clinical and operational barriers: supply/access to infusions, staff comfort, and coordination with cardiology. Council members agreed it would be useful to invite Rod Marriott to present on diversion and IV medication barriers and to have Stacy Sinclair provide an update on the Connecticut CAPC state scorecard.
The council did not adopt any policy changes during the meeting but asked staff to reach out to potential presenters to address supply, training and regulatory barriers to home IV therapies.
