NHIA develops professional practice standards to:
NHIA’s practice standards represent a consensus of professional judgment, expert opinion, and documented evidence. They provide guidance and direction to NHIA members and other audiences who affect the home infusion industry, and the patients served. Their use may help to comply with federal and state laws and regulations, meet accreditation requirements, and improve patient care. They are written to establish reasonable goals, to be progressive and challenging, yet attainable as best practices in applicable home or alternate site settings.
Draft Practice Standard – When to Send an Anaphylaxis Response Kit for Patients Infusing Medications at Home
The purpose of ensuring an anaphylaxis response kit is available is to minimize serious adverse events, prevent unplanned hospital or emergency visits, and avoid disruptions in treatment. Anaphylaxis is a severe, rapid-onset allergic reaction that can progress to airway compromise, hypotension, or shock1,2; drug-induced anaphylaxis can occur through any route of exposure and progress within minutes.
Clinicians are responsible for participating in the decision-making process of ensuring a patient has an anaphylaxis response kit, as outlined in Practice Standard for Anaphylaxis Kit Medication Selection. NHIA has developed this practice standard to help clinicians assess situations and determine when an anaphylaxis response kit is needed.
Draft Practice Standard – Anaphylaxis Kit Medication Selection
The purpose of anaphylaxis kit medication selection is to respond to an adverse event and stabilize the patient’s situation until emergency services can be received. Following physician prescription orders, the Pharmacist and Nurse are responsible for participating in the selection of medications for administration in the event of an anaphylactic reaction in a patient infusing medication at home. Organizations should reference NHIA standards for anaphylaxis kits and develop internal standard operating procedures (SOP) for determining when an anaphylaxis kit should be sent using applicable laws, regulations, and accreditation standards. SOPs should be individualized based on clinical judgment, the patients served, and the medications administered. NHIA has developed guidance to help clinicians assess situations and determine what medications are recommended to include in an anaphylaxis kit.
Draft Practice Standard – Recommendations for Assessment of Risk: Blinatumomab Handling During Receiving, Compounding, Administration, and Disposal
Blinatumomab (BLINCYTO) is a NIOSH Table 2 hazardous drug that qualifies for a documented Assessment of Risk (AOR) rather than full USP <800> containment, since no manufacturer CSTD compatibility data exist. This standard provides organizations with a risk-based framework for establishing appropriate handling practices. It guides facilities through considerations such as confirming NIOSH status, annual review by the Designated Person, receiving and storage, compounding practices and PPE, dedicated-line administration, and spill, waste, and transport procedures. The framework is designed to help each organization establish, document, and justify its containment and handling decisions.
Draft Practice Standard – Providing a Back-up Electronic Mechanical Pump for Patients Infusing Medications at Home
The purpose of providing a back-up electronic mechanical pump is to ensure patient safety and minimize adverse events, avoid unplanned hospitalizations and emergency room visits, and prevent disruptions in treatment. The Pharmacist and Nurse are responsible for evaluating the patient, therapy, and operational factors that contribute to the need for a back-up electronic mechanical pump when delivering parenteral medications to patients infusing medications at home. NHIA has developed this practice standard to help clinicians assess situations and determine when a back-up electronic mechanical pump is recommended.
Practice Standard for Pharmacist Documentation – Initial Assessment and Plan of Care
Comprehensive, accurate documentation is essential to continuity of care, medication safety, and positive patient outcomes. Pharmacists play a critical role in maintaining detailed patient records that support individualized care planning, interdisciplinary collaboration, regulatory compliance, and effective care transitions. As pharmacy practice in the home infusion setting continues to expand, standardized documentation practices are increasingly important. This practice standard establishes clear guidelines to promote consistency, accuracy, and high-quality clinical documentation, ultimately enhancing patient safety and the overall quality of care.
Electronic Mechanical Pump Selection for Home Administration of Infusion Medications
Choosing the appropriate infusion method/device selection promotes safety, minimizes adverse drug reactions (ADRs) and therapy disruptions, avoid hospitalizations and emergency department use, and promotes adherence. By developing a Practice Standard, NHIA can encourage appropriate use of pumps and educate stakeholders (manufacturers, regulators) about how equipment is used in home infusion.
These practice standards should not be viewed as NHIA requirements. The use of NHIA’s practice standards by members and other practitioners should be assessed and adapted based on independent judgment.
Areas of practice are identified where information and direction are necessary to promote general standards and quality.
The NHIA Quality and Standards Committee, comprised of home infusion professionals, performs a comprehensive review of available evidence. Committee members who are clinical and research experts collaborate on the topic, reviewing industry trends and other data sources such as membership, community, best practices, industry research, review of published literature, or other practice guidelines. A draft practice standard is developed and reviewed by the committee members, and revisions to the draft are incorporated based on consensus.
A formal draft of the practice standard is presented for public comment. At the close of the comment period, the committee reviews the commentary and proposed revisions. The committee makes recommendations prior to final approval of the published standard.