Reply To: Infusion Center Reaction Response Protocols

  • Barbara Cuccovia

    September 2, 2022 at 8:22 pm


    We have 2 dedicated NPs who staff all multi-day chemotherapy, sick visits, and infusion reactions¬† in our infusion space. Patients are seen and cleared for their multi-day chemotherapy by their provider but then subsequent days the patients is seen by the infusion NP. I instituted this new model in 2020 and had the primary disease specific NPs who used to cover these patients wonder how they ever did it without the infusion NPs. We also have a fellow/primary patient model, so now there is clear coverage for infusion patients when fellow’s patients come in on an alternate clinic day when their fellow is not on site.

    Happy to discuss further,
    Barb Cuccovia
    Dana-Farber Cancer Institute

    Barbara Cuccovia, MSN,RN,BMTCN
    Nurse Director
    Brighton, MA
    United States
    Original Message:
    Sent: 08-31-2022 11:18 AM
    From: Chelsi Jentsch
    Subject: Infusion Center Reaction Response Protocols

    Hi all,

    I’m seeking insight on how other institutions manage any reactions that occur with Non-Hem/Onc infusion patients.

    At Rainbow Babies and Children’s Hospital, our Hem/Onc clinic serves also as the organization’s pediatric infusion center for other subspecialties (e.g., GI, Rheumatology, Endocrine, AAI, Neurology). Any Non-Hem/Onc patients are referred to us by their specialist as a nurse visit. Those providers are present in our clinic, but they are elsewhere within the hospital. The only providers in our clinic are Peds Hem/Onc.

    When a reaction occurs within our clinic with our Non-Hem/Onc patients, our Hem/Onc providers serve as the first responders while we attempt to get in touch with the patient’s specialist. We do not have any standards around expected response time, so it’s been very difficult to get them to come see their patients. Even when providers do come up to see their patients, their involvement is minimal.

    I’m curious what other infusions sites are doing. Although we are ambulatory, we are an OH space. Do you utilize hospitalists? Do you have a provider responsible to respond/attend to Non-Hem/Onc patients?

    Any insight is helpful.

    Thank you!

    Chelsi Jentsch, MSN, MHSA, RN, CPHON
    Nurse Manager – Outpatient
    Rainbow Babies & Children’s Hospital
    Cleveland, OH
    United States