Podcast: Play in new window | Download

If you want to know what resources need to be in place for home TPN, stay tuned. I will explain today.

My name is Patrik Hutzel from intensivecareathome.com where we are sending critical care nurses into the home for predominantly long-term ventilated adults and children with tracheostomies. We also provide critical care nurses into the home 24 hours a day for home TPN. So, let me explain.

We’re having more and more inquiries about home TPN and in case you’re wondering what TPN is, TPN stands for total parenteral nutrition. In Layman’s terms, it is intravenous nutrition.

So, what needs to be in place? What needs to be in place is a central line, a PICC (Peripherally Inserted Central Catheter) line, a Hickman’s line or a port catheter. Now, all of them we can manage at home because it’s the skill of a critical care nurse to manage a central line, a PICC line, Hickman’s line or a port catheter. Once any of those lines is in place, then TPN can be used.

Now, TPN needs to be prescribed by a gastroenterologist or by an ICU consultant/intensivist. We have the network to have those doctors, so we can definitely help you with the network. Then once that’s in place, then the connection needs to happen. So, what I mean by that, TPN needs to be connected. It needs to be done sterile. Once again, that’s where the skill of our critical care nurses is coming in, that’s managing, once again, the central line, a PICC line, Hickman’s line, and port catheter is predominantly the skill of critical care nurses.

The same happens when the TPN needs to be disconnected. So, what happens is, you connect the TPN and then it’s running over 12 or 24 hours depending on what’s needed for a particular patient. Then at the end of the infusion, it needs to be disconnected, and the line needs to be flushed, the dressing sometimes needs to be changed. The line needs to be locked sometimes with heparin or with hep-lock or with TauroLock. Once again, those are medications that can only be given by a critical care nurse in the home care environment. That’s it in a nutshell.

So, all can be done at home. No need for you or for your loved one to stay in hospitals, for God knows how long, if the TPN is the issue and you don’t know how to go about it at home. I strongly encourage you to reach out to us if that is your situation and we can help you at home pretty fast. We’ve got the network, doctors, nurses, and equipment. We can also set up the equipment, the TPN with the supplier or with pharmacy. There’s no issue there. We’ve done it many times and we can set up the network for you and for your family pretty quickly as well.

Now, like I said, with Intensive Care at Home, we are currently providing 24-hour critical care nurses at home for ventilation, tracheostomy, Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure) ventilation without tracheostomy, tracheostomy without ventilation, home TPN, home IV potassium infusion, and home IV magnesium infusion. We’re also providing port management, central line management, PICC line management, as well as Hickman’s line management, and we’re also providing palliative care services at home.

We’re also sending our critical care nurses for emergency department bypass services. We have done so successfully as part of a program at the Western Sydney Local Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home instead of them going to ED. We’re also cutting the cost of an intensive care bed by around 50%. An intensive care bed costs around $5,000 to $6,000 per bed day. Our service costs between $2,500 and $3,000 a bed per bed day. We’re freeing up the ICU bed and we’re improving quality of life for patients and their families. So, it’s a win-win situation all around.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We are a NDIS (National Disability Insurance Scheme) approved service provider all around the country, TAC (Transport Accident Commission) and WorkSafe in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme) in Queensland and DVA (Department of Veteran Affairs) all around the country. Our clients and we as a provider have also received funding through public hospitals, private health funds as well as departments of health.

We are the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2024. We’ve been having this accreditation achieved since 2012. No other provider in Australia has achieved that high level of accreditation and has created that much intellectual property for Intensive Care at Home nursing than we have. We are therefore in a position to employ hundreds of years of critical care nursing and intensive care nursing experience in the community combined. No other provider in the community brings this much expertise into the community than we do.

If you’re at home already and you’re watching this and you realize you don’t have the right level of support, then I encourage you to reach out to us as well. Or if you’re stuck in ICU long-term or in a hospital with complex medical or disability issues, please reach out to us. We can help you. We have helped all of our clients with the advocacy and with the funding, otherwise we would not be in business.

Also, I’ll give you an example if you’re at home already. Our very first client, we proved our concept over 10 years ago. He was at home on a ventilator with the tracheostomy with support workers. Those support workers, of course, couldn’t keep the client at home. He was at risk of dying; he was going in and out of ICU all the time. Sending a support worker to a ventilated and tracheostomy client is like flying the airplane with a cabin crew instead of the pilot. You know what happens then, it’s the same. So, we were proving our concept there in no time because the client never ever went back to ICU ever again when we worked with him. So that’s how we proved that concept. We were successfully advocating for the right level of funding, that’s how deep our area of expertise goes.

That’s why I said I’m telling you, if you’re at home and you realize it’s dangerous, you don’t have the right level of support, you’re going back to the hospital all the time, please reach out to us. We can help you turn your situation around.

That’s also why we’re providing Level 2 and Level 3 NDIS Support Coordination. We have a team of NDIS support coordinators, and they have a wealth of knowledge. I’ll put a link into the written version of this blog where I have done an interview with Amanda Riches, one of our NDIS support coordinators. We’re also providing TAC case management in Victoria and WorkSafe with Lucy McCotter and Amanda Riches.

If you’re a NDIS support coordinator or a case manager from another organization watching this and you’re looking for nursing care for your participants, please reach out to us as well. If you’re looking for funding for more nursing care for your participants and you don’t know how to go about it and what evidence to provide, I also encourage you to reach out to us. We can help you with the right advocacy. We also provide NDIS specialist nursing assessments done by critical care nurses with a legal nurse consulting background.

If you are a critical care nurse and you’re looking for a career change, we’re currently hiring for our clients and for critical care nurses in the home in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, and in Warragul in Victoria. If you have worked in critical care for a minimum of two years pediatric ICU, ED, and you have already completed the postgraduate critical care nursing qualification, we will be delighted to hearing from you.

I have a disclaimer because we are offering a tailor-made solution for our clients, which includes regular staff. Our clients want to have the same staff coming over and over again because they are so vulnerable and so special. It’s all about building those critical relationships with our clients and with our other team members and having regular and stable teams. That means if you’re looking for agency work where you can come and go, this is not going to be the right fit for you because we want regular staff, and our clients want regular staff. Everything that we do is driven by our clients and you need to be able to work with that.

If you’re an intensive care specialist or an ED specialist, we also want to hear from you. We are currently expanding our medical team as well.

We can also help you eliminate your bed blocks in ICU and ED for your long-term patients or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help you take the pressure of your ICU and ED beds, and in most cases, you won’t even pay for it. But even if you do pay for it, it’s much more cost-effective than what you’re paying in ICU or ED for.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, respiratory wards, etc., please reach out to us as well. We can help you fast eliminate some of your bed blocks.

If you’re in the U.S. or in the U.K. and you’re watching this and you need help, we want to hear from you as well. We can help you there privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to info@intensivecareathome.com.

If you like my videos, subscribe to YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, share this video with your friends and families, and leave your comments below what you want to see next, what do you think about today’s topic and what insights you have from this video.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care for now.