| Summary: | Significance & Background: Antineoplastic therapy administration demands strict adherence to safety protocols during medication verifications. Staff in an outpatient infusion clinic noted challenges performing timely, independent pre-administration order and dose verifications with two nurses. These challenges led to delays in treatment and staff and patient dissatisfaction. To address these issues and to standardize the verification process, we piloted a quality improvement initiative utilizing a centralized verification nurse to provide real-time, independent antineoplastic verifications prior to patients receiving treatment. Purpose: The purpose of the quality improvement initiative was to improve interdepartmental communication, minimize treatment delays due to verification inefficiencies, and improve staff satisfaction using a centralized verification nurse. Interventions: A dedicated verification nurse was stationed near the pharmacy dispensing depot to perform order and dose verifications for antineoplastic drugs. A workflow was developed to ensure consistent and independent verifications by each nurse. A bin system (unverified and verified) facilitated communication and drug routing between nursing and pharmacy. Electronic messaging between the verification nurse and infusion nurse supported real-time coordination, while critical safeguards such as patient assessment parameters (e.g., weight, blood pressure, oxygen saturation) were embedded into the workflow. Temperature-sensitive drug protocols and other workflows for drugs delivered after the closure of the pharmacy dispensing depot were integrated into the process. Results: Observations during the pilot period indicated improved consistency in verification documentation, enhanced communication between pharmacy and nursing regarding dose readiness, and reduced turnaround times for verifications. The verification nurse reviewed a daily average of 88 (range 81-107) antineoplastic doses for 67 (range 57-78) patients during the pilot. Communication gaps were reduced through standardized electronic messaging for hand-offs between nurses. Nursing staff reported increased confidence and error reductions in the verification process. Qualitative feedback from surveys showed staff perceptions of increased time and ability to focus on direct patient care activities, fewer interruptions, and decreased stress. Discussion: Initial outcomes supported the viability and value of a centralized verification nurse in enhancing verifications and promoting staff satisfaction. Staff feedback highlighted improved workflow cohesion and increased nursing time spent with patients. Next steps include optimizing staff coverage and expanding the role to other infusion areas. Future state goals include exploring virtual nursing with video enhanced technology to support verification procedures. This initiative underscores our institutional commitment to aligning with Oncology Nursing Society (ONS) best practices for chemotherapy administration.
|
|---|