Congress Abstracts 2006

115

HYPERSENSITIVITY/ANAPHYLAXIS/ALLERGIC REACTION PROTOCOL. Donna Cirigliano, RN, OCN^®, Donna Delicio, RN, MSN, and Elizabeth Troxler, RN, BSN, OCN^®, Overlook Hospital, Summit, NJ.

In the outpatient chemotherapy setting we administer many medications and transfusions that have a high incidence of hypersensitivity/anaphylactic reactions. We provide these services for many physicians including Hematology/Oncology, Gastroenterology, Infectious Disease, and Rheumatology to name a few. None of which are located on site.

The purpose of our project was to develop and implement a standard protocol for the management of hypersensitivity/anaphylactic reactions to IV infused agents.

An ADE multidisciplinary task force consisting of Nurses, Pharmacists and Physicians was formed. A hypersensitivity/anaphylactic reaction protocol and a corresponding "Flowgorithm" was developed based on ONS Standards of Care. This "Flowgorithm" allows RNs to treat patients who experience hypersensitivity/anaphylactic reactions immediately while attempts are made to contact the physician. "In the event of a Hypersensitivity/Anaphylaxis/Allergic Reaction institute the Outpatient Infusion and Chemotherapy Day Room Hypersensitivity/Anaphylaxis/Allergic Reaction Protocol" is printed on pre-printed Doctor Order forms. Once the "Flowgorithm" is implemented it then acts as documentation of the reaction and the nursing actions. The protocol then becomes part of the patient's permanent record.

(The "flowgorithm" and pre-printed Doctor Order forms are easily available for review upon request).

The multidisciplinary task force reviewed several cases in which the protocol was instituted and found it to be effective in rapid response to hypersensitivity/anaphylactic reactions. Our physicians have been very satisfied with the process and the outcomes.

This clinical practice is applicable to all oncology administration centers that administer high risk medications with the potential for hypersensitivity/anaphylactic reactions.

This tool can be easily utilized or transformed to meet the needs of other outpatient infusion areas. It is a key element of oncology nursing practice in the management of hypersensitivity/anaphylactic reactions.