Lisa Rathman, MSN, of Lancaster General Hospital, discusses the benefits of subcutaneous furosemide in nursing homes and facilities outside the hospital.
Lisa Rathman, MSN: The benefit of subcutaneous lacix (furosemide) is an opportunity to be able to diuresis patients that are mildly symptomatic with congestion, or mild-to-moderately symptomatic but hemodynamically stable, in the outpatient setting, in the home, in the skilled nursing facility, and not have to bring them into the hospital or give them IV diuretics in the clinic. Giving IV diuretics has some issues as far as you have to have a line, and if you give the patient IV diuretics in the clinic, in the time frame for them to drive from point A to point B can be problematic. This gives an opportunity to give the patient diuresis but in their home setting.
In my current hospital situation, we partner with 10 facilities and we are starting to do IV diuretics in the nursing homes, but before that, it was impossible to get IV diuretics. It's getting better because we're partnering and they're seeing the benefits of trying to keep patients in the skilled facility, not go back to the hospital at a rapid pace. So they bought into it, but it's a lot of work for them. They don't have the staff. I think that, for them, it would be so much easier to be able to do a subcutaneous injection rather than doing IV, and I think that's absolutely clear. The other place I think would be very helpful is personal care homes because they definitely do not have nursing staff to do that. They may just have medical assistants who don't have the ability to give any kind of IV diuretics.