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New hydration service provides freedom, flexibility to pediatric patients

Susanne Conley (left) and Kathleen Houlahan display the home hydration kit.
(Sam Ogden photo)

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 the Jimmy Fund Clinic and Children's Hospital Boston, eligible patients have the option of receiving intravenous fluids from a small pump carried in an easy-to-wear backpack.

The program, known as a 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. Though it was conceived as a way to free up inpatient beds in the Children's oncology unit, the service has become popular with patients and their families for the respite it provides from hospital routines and schedules.

"When your child is going through the day-to-day challenges of receiving chemotherapy, any bit of normalcy you can provide is a bonus," says Jeffrey Hampton of Greenfield, whose daughter, Alexandria, has used the pump during her treatment. Hydration is a standard complement to chemotherapy, explains Kathleen Houlahan, MS, RN, the hematology/oncology and 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, says Susanne Conley, RN, MSN, CPON, of the Jimmy Fund Clinic.

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.

All in one

Families opting 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 - a simple process of disconnecting and reattaching plastic tubing – and when to call a doctor or the pump manufacturer if problems arise. The manufacturer, INFU Systems, offers a toll-free number for user questions and troubleshooting of pumps.

The pumps have an excellent performance record, clinic staff note, 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, 15 have opted in, Houlahan says. Many families have recommended it to others.

Although home hydration has been used in adult cancer treatment for many years, it is relatively new in pediatric oncology, Conley remarks. In some parts of the country, it has been difficult to find visiting nurses who are trained in pediatric IV systems.

"This system is so easy to use that parents have no trouble with it," Conley says. "Because it enables them to bring their children home at night, where everyone is more comfortable, it lessens the burden on the entire family. It has been a useful way to increase the quality of care."

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