Congress Abstracts 2003

76

EFFICIENT SYSTEM TO SCHEDULE CHEMOTHERAPY AND SUPPORT THERAPIES FOR ONCOLOGY NURSES. Julene Diedrich, RN, OCN^®, and Darlene Pawlik Plank, RN, MSN, AOCN^®, Marshfield Clinic, Marshfield, WI.

Oncology nurses are challenged to efficiently schedule chemotherapy regimens that vary widely in the amount of direct nursing care required, length of treatment, multiple day treatments, and support therapies required. A large oncology ambulatory care clinic in the rural Midwest developed a chemotherapy scheduling system to address these issues.

Oncology nurse chemotherapy schedules typically follow the physician office visits. In general, the majority of patients receiving chemotherapy tend to show up in the chemotherapy infusion center between 10:00 am and 2:00 pm. The flow of patients through the chemotherapy infusion center at these times created a gridlock for nurse and/or room availability. Oncology nursing staff, along with the appointment coordinator (AC) and oncology managers, identified criteria for best appointment practices and utilization of space and staff.

A return appointment sheet was developed to capture the nuances of chemotherapy scheduling and to drive the appointing process. Patients with a new diagnosis or patients who required a change in treatment were often added onto an already busy schedule. A nurse master schedule (NMC) was created to include structured appointment times that accommodated patients new to treatment and with treatment changes. The NMC also included staggered lunch breaks for the nurses. All chemotherapy regimens were categorized to provide the AC with the amount of time required by the oncology nurse to initiate therapy and the total length of treatment time. This guideline provided the AC with information needed to appropriately appoint the patient. AC guidelines focused on spreading the chemotherapy treatments throughout the day. When feasible, patients being seen only by the nurse are scheduled early or late in the day to avoid the peak volume times.

As a result of fine-tuning the appointing system, patient and staff satisfaction has improved significantly.