| Sumario: | Significance & Background: Timely care is vital for patients requiring infusion therapy. Oftentimes, Infusion Centers must balance Oncologic care with other specialty infusion services including Hematology, Gastroenterology, and Rheumatology. Our center offers services within a 9 chair Infusion Center emphasizing the need for safe, efficient care to maximize capacity utilization and chair turnover. Purpose: Members of the team recognized delays in timely patient care due to an increase in adverse drug reactions requiring rescue medication support and additional nursing care. Secondary effects included decreased staff confidence in managing patient assignments, patient dissatisfaction due to longer wait times, and inefficient use of chair time. Interventions: A multidisciplinary approach was utilized to review opportunities for improvement. Adverse drug reactions January-April 2025 were reviewed and evaluated for areas of opportunity. One chemotherapy-related adverse reaction occurred January to April, and 8 non-chemotherapy adverse reactions, specifically related to iron infusions. A sharp increase in iron reactions in March and April was also noted. January (0%, n=19), February (0%, n=37), March (13%, n= 79) and April (13%, n=83). Evaluation revealed an opportunity to closely examine IV iron orders to potentially reduce adverse reactions therefore improving overall operational efficiency. Iron orders entered in the EMR Therapy Plan were reviewed. Order sets included a Provider Communication notating an option for premedicating patients with history of multiple drug allergies, moderate to severe asthma or immune-mediated disease or prior reaction to another IV iron formulation. Review of patients who experienced an adverse reaction during the iron infusion showed an opportunity to address potentially preventable reactions in patients who met premedication criteria but did not have orders for premedications. Implementation of premedication requirements for patients receiving IV iron infusions who meet eligibility criteria began April 2025. Nursing team members and the clinical pharmacy specialist reviewed therapy plans proactively for premedication eligibility. Results: Post-Implementation Data revealed decreased iron reactions following the implementation of our new processes. May (10%, n=86), June (5%, n=67), July (0%, n=103), August (3%, n=115). Discussion: Significant reductions in adverse reactions during iron infusions were noted. Mitigating infusion reactions led to increased efficiency in chair turnover and increase in overall infusion volumes. A secondary outcome noted included an increase in nursing confidence related to managing their assignment. Our care team continues to follow this newly established protocol due to positive patient care outcomes.
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