scholarly journals Incidence of drug extravasation: A three year experience with IV chemotherapy administration by nurse practicioners in an outpatient clinic

1986 ◽  
Vol 111 (S1) ◽  
pp. S63-S63
Author(s):  
J. Anagnou ◽  
H. -J. Schmoll ◽  
H. Poliwoda
Keyword(s):  
Outpatient Clinic ◽  
Chemotherapy Administration ◽  
Drug Extravasation

Effect of early palliative care on health care costs in patients with metastatic NSCLC.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6004-6004 ◽  
Author(s):  
Joseph A. Greer ◽  
Pamela M McMahon ◽  
Angela Tramontano ◽  
Emily R. Gallagher ◽  
William F. Pirl ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Outpatient Clinic ◽  
Cost Savings ◽  
Care Group ◽  
Early Palliative Care ◽  
Metastatic Nsclc ◽  
Chemotherapy Administration ◽  
The Difference ◽  
Mean Cost

6004 Background: Introducing palliative care soon after diagnosis for patients with metastatic non-small cell lung cancer (NSCLC) leads to improvements in quality of life, mood, end-of-life care, and possibly survival. We sought to investigate whether early palliative care is also associated with health care cost savings. Methods: This secondary analysis is based on a randomized controlled trial of 151 patients with newly-diagnosed, metastatic NSCLC presenting to an outpatient clinic at a tertiary cancer center between 6/2006 and 7/2009. Participants received either early palliative care integrated with standard oncology care or standard oncology care alone. We queried participants’ electronic health records as well as our institution’s billing database to collect data on frequency and costs of outpatient clinic visits, inpatient hospitalizations, chemotherapy administration, and hospice services. The primary outcome was the difference in average resource use costs during the final month of life between groups. Results: By 18-month follow up, 133 (88.1%) participants had died, and 125 (82.8%) had available data for this analysis. Participants in the early palliative care group had a mean cost savings of $2,282 (median=$2,432) per patient in total health care expenditures during the final month of life compared to the standard care group. The difference was primarily accounted for by lower costs for inpatient visits (mean saving per patient=$3,110) and chemotherapy administration (mean saving per patient=$640). Although expenditures for outpatient clinic visits were similar between groups, the costs for hospice services were greater for the early palliative care group because of the longer lengths of stay in hospice care (mean cost per patient=$1,125). Conclusions: Early palliative care for individuals diagnosed with metastatic NSCLC not only improves multiple patient outcomes but also may be associated with lower hospital resource use costs, primarily through decreased inpatient visits and chemotherapy administration at the end of life.

scholarly journals Integrative Approach Successfully Improves Safety of in-Patient Chemotherapy and Reduces Health Care Costs

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4524-4524
Author(s):  
Meir Preis ◽  
Ziad Abu-Salah ◽  
Ravit Melberger ◽  
Leah Zack ◽  
Judith Mohilever ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Record ◽  
Health Care Costs ◽  
Outpatient Clinic ◽  
Inpatient Setting ◽  
Chemotherapy Drugs ◽  
Chemotherapy Administration ◽  
Complex Process ◽  
Administration Time ◽  
Care Costs

Abstract Introduction Patients with hematological malignancies often require inpatient chemotherapy treatment to administer continuous infusion of chemotherapy drugs and allow better monitoring. Inpatient setting includes multiple caregivers with different level of expertise - physicians, nursing staff, pharmacy and administrators. Many patients are seen by their hematologist in an outpatient clinic where the chemotherapy plan is written. The patient is then admitted to the inpatient floor for therapy. However in many hospitals there are 2 different electronic medical record systems that don't necessarily communicate properly. In addition, the inpatient setting utilizes more health care resources and is undoubtedly more expensive than the ambulatory care. In this paper we describe an integrative process of establishing safer and better care to hematological patients admitted for inpatient chemotherapy. Methods A multidisciplinary team was established incorporating physicians, nurses, pharmacists and IT. We conducted focused observations and mapped the process. Failure Mode Effect Analysis (FMEA) was preformed to identify the most important issues needing intervention. An integrated electronic medical record interface was generated to enable online streaming of communication between different entities in the hospital - inpatient floor, outpatient clinic and pharmacy. We established a dedicated time out of the process. To assess the impact of our work we reviewed charts of randomly selected 18 patients who received inpatient chemotherapy prior to the interventions and continued to monitor records post intervention for the following indicators: 1. Percent of patients who received pre-chemo medications and fluids as prescribed by the hematologist; 2. The difference between a patient's weight on the chemotherapy orders and the actual patient weight as measured on admission; 3. The time difference variability between the planned administration time and the actual administration time of chemotherapy drugs. Results Prior to intervention, 20% of the pre-chemotherapy orders such as anti-emetics or fluids were not done according to the hematologist's request. Following the intervention, 100% of pre-chemotherapy orders were preformed accurately and timely. In 24% of patients' cases there was more than 10% difference between the weight used for chemotherapy orders and weight on admission. No significant difference was noted following intervention. In 50% of cases there was more than 2 hrs delay in chemotherapy administration on the following day. Following intervention there was no incidence of more than 2 hrs delay in chemotherapy administration. These interventions resulted in a significant decrease in hospital stay (7.4 vs. 4.7 days). Conclusions The Multidisciplinary team's approach is critical in a complex process as inpatient chemotherapy administration. FMEA is an essential tool to assess the severity of different failures of a complex process to prioritize interventions. Integrated electronic medical records interface helps improving communication between different providers and results in a better and safer patient care as well as reduces health care costs. Disclosures No relevant conflicts of interest to declare.

A cross-section questionnaire to evaluate patients’ satisfaction with totally implanted access ports (Port-a-Cath; PAC) and analysis of PAC-related complications at a tertiary care center.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20693-e20693
Author(s):  
Christoph Minichsdorfer ◽  
Thorsten Fuereder ◽  
Anna Sophie Berghoff ◽  
Gabriel Marta ◽  
Bruno Maehr ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Venous Access ◽  
Peripheral Vein ◽  
Chemotherapy Administration ◽  
Intravenous Drugs ◽  
Drug Extravasation ◽  
Potential Risks ◽  
Mean Time

e20693 Background: PACs are used for the administration of intravenous drugs. These devices have therefore become valuable tools for the application of chemotherapy in cancer patients (pts). Methods: During the period from 11.2012 to 01.2013, pts were invited to answer a simple questionnaire concerning quality-of-life and satisfaction with their respective PAC. Retrospective data regarding to PAC-related complications were collected by searching patient’s medical history. PAC-related thrombosis were defined as non-compressibility of the axillary or subclavian vein on ultrasound; PAC-related infections were defined as documented bacteraemia with a positive blood culture taken from the device in the absence of positive peripheral blood cultures. Results: A total number of 116 pts were included. Mean time since PAC implantation was 16.9 months. Complications during implantations occurred in 8 pts (6.9%), with bleeding and haematoma being the most frequently observed events; three patients experienced postsurgical pneumothorax (2.6%). Complications arising after PAC implantation consisted of infections (9 pts; 7.7%), drug extravasation (8 pts; 6.9%), PAC malposition (3 pts; 2.6%), and thrombosis (1 pt; 0.8%). PAC infections were caused most commonly by Pseudomonas aeroginosa (3 cases). One quarter of all pts reported that their PAC interfered activities of daily life. In 15 cases (13%) the PAC caused pain, especially when moving the arm (11 pts; 9.5%); only 6% reported that PAC punctuations were more painful than accessing a peripheral vein. 98 pts (84%) agreed that the PAC alleviates the administration of therapy. Indeed, the vast majority (84%) would once again choose a PAC for chemotherapy administration. Conclusions: PACs are valuable tools to ease the burden of chemotherapy administration. Most patients were satisfied, as PACs provide a relatively easy and safe way of venous access. Nevertheless, implantation and maintenance of these systems carry potential risks.

Is it possible to treat acute mild to moderate colonic diverticulitis by oral antibiotic and carbonated beverage in outpatient clinic?

2001 ◽  
Vol 120 (5) ◽  
pp. A733-A733
Author(s):  
A MIZUKI ◽  
H NISHIYA ◽  
K FUKUI ◽  
T HAYASHI ◽  
N TSUKADA ◽  
...  
Keyword(s):  
Outpatient Clinic ◽  
Oral Antibiotic ◽  
Colonic Diverticulitis ◽  
Carbonated Beverage

Abstract #270 Clinical Experience in the use of Glp 1 Analogs in an Endocrinology Outpatient Clinic in Tegucigalpa, Honduras

2019 ◽  
Vol 25 ◽  
pp. 106
Author(s):  
Maria Alejandra Ramos Guifarro ◽  
Irma De Vicente ◽  
Scarleth Betzabel Rodas ◽  
Daniel Andrés Guifarro Rivera
Keyword(s):  
Clinical Experience ◽  
Outpatient Clinic
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