Home Health has had a patient that has needed intermittent infusion therapy at home for several years. She has had repeated problems with PICC line clotting and needed visits to the infusion clinic on two occasions, along with as needed visits from the Home Health staff on two occasions for Cathflo/Activase (meds) instillations to open up a central line.

Cathflo and Activase medications are very expensive for the medication alone (about $800 for one ampule) but when nursing services and medical interventions are needed the costs multiply. She has needed to have the PICC line replaced several times as well. She is currently being seen by various doctors for a variety of illnesses.

Ashley Renner called the primary care physician on December 23, 2011 about possibly running coagulation tests on her blood, to see if that could be a possibility for so many issues with clotting of PICC line versus catheter/patient compliancy issues. This patient has also shared during the course of home visits that her sister, who is three years older than she has had several strokes (patient is only 49 years old and soon will be 50, so young woman). The doctor ordered the tests as requested. It was found that this patient does have a blood disorder and will be following up with the hematologist regarding clotting disorder.

The primary care physician told Ashley that she has only seen two cases of this blood disorder in 20 years. The doctor’s office was very impressed with Ashley’s recommendation and follow up! I believe Ashley’s intervention and concern for patient safety saved this patient from serious complications and injury. Treatment and follow up will be done promptly since the results of the coagulation studies identified a potentially life changing disease process is occurring with this patient. The patient is very grateful for Ashley’s care and concern for her health.