Reply To: Standardized Chemo Concentrations

  • Mary Lynn Rae

    Member
    March 10, 2020 at 5:15 pm

    .  Do your orders provide you with the rate in which the hydration should be running with each chemo or does nursing calculate this? Yes the rate is ordered and based on m2

    2. Do you have a specific way that nursing is flagged on those high dose chemo’s which require a total fluid rate of 200mL/m2/hr rather than the typical 125mL/m2/hr? Part of the orders in Beacon

    3. When building the line do you attach an extension to give patients additional wiggle room with infusions that are longer than just a couple of hours? If so, do you run a post chemo flush other than the ordered post hydration? We just have a separate line for post hydration; chemo tubing is single use only

    4.  Can you share any advice that you may have after having worked through this process?

     

    Thanks,

    Mary Lynn

    Mary Lynn Rae, MSN, RN, CPHON

    NPD Practitioner/Clinical Educator Hem/Onc/SCT

    Ann & Robert H. Lurie Children’s Hospital of Chicago

    T 312.227.4224 | mlrae@luriechildrens.org | luriechildrens.org

    225 East Chicago Avenue, Box 248, Chicago, Illinois 60611-2991

     

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    ——Original Message——

    Recently we made the switch to Beacon and with that there was the decision to make chemo concentrations standardized.  Previously, pharmacy would prepare the chemo and hydration in the same bag (with a total fluid of 125mL/m2/hr).  With standardizing concentrations nursing workflow has changed quite a bit because pharmacy sends us straight drug and then nursing runs hydration concurrently to a total fluid rate of 125mL/m2/hr. Nursing is given the rate in which chemo is administered, but nursing is calculating the hydration fluid rate independently (with 2 nurse verification of course).  I have a couple of questions…

    If your institution administers chemo utilizing the method described above can you please take a moment to provide some advice.

    1.  Do your orders provide you with the rate in which the hydration should be running with each chemo or does nursing calculate this?

    2. Do you have a specific way that nursing is flagged on those high dose chemo’s which require a total fluid rate of 200mL/m2/hr rather than the typical 125mL/m2/hr?

    3. When building the line do you attach an extension to give patients additional wiggle room with infusions that are longer than just a couple of hours? If so, do you run a post chemo flush other than the ordered post hydration?

    4.  Can you share any advice that you may have after having worked through this process?

    ——————————
    Heather Hartlage, MSN,RN,CPON
    Clinical Nurse Education
    Addison Jo Blair Cancer Care and Renal Center
    Norton Children’s Hospital
    Louisville, KY United States
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