Congress Abstracts 2004

59

MONITORING PATIENT SAFETY WITH ORAL CHEMOTHERAPEUTICS: A NURSE MANAGED PROJECT. Paula Caron, MS, ARNP, AOCN^®, Dartmouth Hitchcock Medical Center, Lebanon, NH, and Rita Vied, RN, OCN^®, and Kerry Rosenthal, RN, OCN^®, Frisbie Memorial Hospital Center for Cancer Care, Rochester, NH.

The purpose of the Oral Chemotherapy Treatment Program developed by the oncology nursing team at Frisbie Memorial Hospital Center for Cancer Care is to promote safe administration, patient compliance, and toxicity monitoring of prescribed oral chemotherapeutics. A continuous challenge facing caregivers in hematology and oncology is promoting safety for patients receiving cytotoxic drugs. This responsibility is entrusted to oncology nurses because of their expertise in side effect and toxicity management, as well as patient education. The growing number of drugs available for oral delivery is presenting caregivers with new challenges, namely, drug procurement, accurate delivery, and patient compliance.

A tracking system has been put into place and is monitored on a dedicated oral chemotherapy flow sheet. Every patient for whom oral chemotherapy is prescribed is monitored via a master list, and a member of the oncology nursing team is responsible for overseeing the oral chemotherapy program. The date of initial administration is entered into the clinic’s computerized reappointment system and on the dedicated flow sheet. Oral chemotherapy follow-ups by telephone appear on the nursing schedule, which is printed daily. The nursing staff also monitor laboratory appointments and call patients with the results of their blood work and any modifications in their prescribed plan.

Initiation of this program has resulted in no errors on the part of the patients in self-administration of their chemotherapy. Side effects and toxicities are discovered early and intervention is prompt. Follow-up visits, while on treatment, reflect accurate documentation regarding dates of cycles, corresponding hematologic values, and associated side effects and toxicities. In the current calendar year, 196 nursing calls have been made to a total of 52 monitored patients.

This model, which goes a long way toward promoting patient safety, can be easily adapted by other nurses working toward monitoring safety for their patients taking oral chemotherapeutics.