Nurse Supported Seamless Service from Rheumatology Clinic to Infusion Unit

Treatment of inflammatory joint disease often requires initiation of regular intravenous therapies which have rigorous safety protocols (Rubbert-Roth. 2012. Jasvinder et al, 2012). In 2008, patients who had been prescribed... [ view full abstract ]

Treatment of inflammatory joint disease often requires initiation of regular intravenous
therapies which have rigorous safety protocols (Rubbert-Roth. 2012. Jasvinder et al,
2012). In 2008, patients who had been prescribed intravenous biologic agents were
admitted to the oncology infusion unit for their initial infusion with a variable and often incomplete workup resulting in delays in infusion, cancellations, patient distress and avoidable errors.

The Rheumatology Nurse (PP) retrospectively selected 20 patients who had first infusions. A request for phone interviews with patients was sanctioned by the consultant. The patients describe their experience of going through the service. Patients reported a lack of trust in the service, that nurses were unsure of the treatment plan and they found the process frightening. A scheme was developed to create a seamless, safe and systematic process such that all patients initiated on infusion therapy had an infusion check list performed which was tailored to account for all parameters for each individual patient relevant to their specific disease and drug.

The first step in the screening involved a counselling session with the Nurse (PP) to explain the process and obtain as much of the screening information as possible and identify any deficits in screening prior to initial infusion.

The completed checklist is then sent to the oncology infusion ward with the prescription and relevant results attached so that patients can be booked for treatment. Since this scheme was launched a total of 406 have been initiated on infusion therapy with no delays or cancellations because of incomplete data.