Agreed Upon Treatment Plan

• Patient received a bolus infusion immediately prior to surgery followed by rFVIII CI at 4 u/kg (100% correction)
• FVIII levels were checked regularly

  –	Once levels were stable at 100% and the patient was stable from an orthopedic standpoint, discharge from the hospital could be considered with CI via CADD pump at home

• Discharged on CADD pump CI after 2 days

  –	PICC line and CI planned for a total of 7 days
  –	Education and transition to CADD occurred in hospital with the collaboration of HTC staff/specialty pharmacy staff
  –	Planned FVIII levels as outpatient then adjust dose as needed

Michelle Witkop, DNP, FNP-BC Doctor of Nursing Practice Bleeding Disorders Nurse Practitioner Northern Regional Bleeding Disorders Center Munson Medical Center	CADD = Computerized Ambulatory Delivery Device