Congress Abstracts 2006

271

COMPUTERIZED ORDER ENTRY: A DYNAMIC INITIATIVE FOR NURSING WITH PATIENTS ON A CLINICAL TRIAL. Deborah Verrier, RN, BSN, and Ellen Toomey-Mathews, RN, BSN, Dana-Farber Cancer Institute, Boston, MA; and Karen Lipshires, RN, BSN, Massachusetts General Hospital, Boston, MA.

The Chemotherapy Order Entry (COE) system is a patient-safety initiative that evolved in part to meet the ongoing challenge oncology nurses face in ensuring that patients receive safe treatment. Multidisciplinary collaboration and constant maintenance ensure that this complex ordering system serves the purpose of accuracy and compliance in a setting with many active clinical trials.

The purpose of the COE system at Dana-Farber/Partners Cancer Care (DF/PCC) is to ensure safe medication delivery by utilizing computerized ordering templates. Inherent risks to the oncology setting, such as, the medication's potentially toxic nature or the dynamic disease state of the patient, present challenges to nursing. The development of templates ensures that the rigorous methods outlined in clinical trials are clear and in compliance.

Approximately 3000 patients receive treatment on therapeutic clinical trials each year. DF/PCC developed specific computerized ordering templates detailing drug, dose, frequency, and instruction information. Collaboration with disease center nurses, pharmacists and physicians create the precise framework for each COE template. In turn the clinicians caring for the patients have safeguards in place to capture potential issues and minimize errors at the administration level for nursing. Clinical trial specific criteria for treatment, standardized side effect management, hypersensitivity reaction management and detailed drug instructions are only a few features of COE. Vigilant scrutiny of amendments as well as the ongoing maintenance intrinsic to a computerized system helps to ensure that nursing has the latest information regardless of trial phase.

The COE system has established 300 templates. Feedback regarding enhancing existing options such as the criteria for treatment and specific drug instruction only serves as testimony that safe medication practices are critical to the treatment of the patient. Determining potential errors prior to an occurrence remains a goal of the COE system.

Nursing is at the forefront of developing innovative approaches to safe delivery of therapy as well as instrumental in the development and implementation of the COE system. The complex nature of oncology patient care coupled with the intricate details of a clinical trial make computerized orders indispensable to nursing.