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Keeping you Safe During Treatment

July 16, 2020

Ways to stay safe during chemotherapy and immunotherapy.

ID
5404

Transcript

  • 00:03Here at Smilow Cancer Hospital and
  • 00:06at our care centers throughout the
  • 00:09region providing high quality care
  • 00:11and keeping you safe during your
  • 00:14cancer treatment is our top priority.
  • 00:17High quality means consistently
  • 00:19providing exceptional care,
  • 00:20keeping you safe means having in
  • 00:22place and following the procedures
  • 00:25necessary to avoid mistakes and errors
  • 00:28that can potentially cause you harm.
  • 00:30Safety is especially important
  • 00:32when it comes to preparing.
  • 00:35And administering chemotherapy
  • 00:36and immunotherapy treatments.
  • 00:37Safety requires all members of your
  • 00:40health care team working together.
  • 00:42And as the patient,
  • 00:44you are the most important
  • 00:46member of the team.
  • 00:47We'd like to use this video to describe
  • 00:51the procedures we have in place to
  • 00:54keep you safe and at the same time
  • 00:57give you an idea of what to expect when
  • 01:01you receive your cancer treatments.
  • 01:03The procedures apply to all chemotherapy.
  • 01:05And immunotherapy medications
  • 01:07that you receive regardless of
  • 01:09how long you are on treatment.
  • 01:11These safety steps will be followed every
  • 01:14time and at every location across the smilow.
  • 01:18Cancer hospital delivery network.
  • 01:19The first element of our safety procedures
  • 01:22occurs even before your actual treatment.
  • 01:25Start.
  • 01:25Your treatment plan is entered into the
  • 01:28computer only by your primary oncologist.
  • 01:31That is the cancer specialist
  • 01:33who knows you well.
  • 01:35And is responsible for making your
  • 01:38chemotherapy treatment decisions.
  • 01:39Your oncologist usually enters the plan
  • 01:41before your first day of treatment,
  • 01:43or what we call cycle one.
  • 01:46This treatment plan is the one that
  • 01:48you discussed with your oncologist,
  • 01:50and agreed was right for you.
  • 01:52Your oncologist will also ask you
  • 01:55to sign a consent form before
  • 01:57you begin your treatment,
  • 01:59and whenever you start a
  • 02:00new treatment regimen,
  • 02:02your treatment plan is made up of cycles.
  • 02:05A cycle means a period of
  • 02:07treatment with chemotherapy.
  • 02:08And medications to prevent side effects
  • 02:11followed by a period of rest or no treatment.
  • 02:15Each cycle also includes pretreatment
  • 02:17blood work and other tests to monitor how
  • 02:21you are responding to the treatment plan.
  • 02:24Treatment plans are like a complex
  • 02:26recipe with instructions for each cycle.
  • 02:29These instructions are also
  • 02:31referred to as orders like a recipe.
  • 02:34They are exact instructions for
  • 02:36pretreatment blood work for the specific
  • 02:38medications you'll be receiving.
  • 02:41And how they are to be given on
  • 02:43the first day of each treatment
  • 02:46cycle you will be seen an examined
  • 02:48by your oncologist or another team
  • 02:51member such as an oncology fellow
  • 02:54or an advanced practice provider,
  • 02:56sometimes called an APP,
  • 02:57meaning a nurse practitioner
  • 02:59or physician assistant.
  • 03:00If there are no abnormal findings and
  • 03:03your blood work is in an acceptable range,
  • 03:06your Oncologist fellow or a PP
  • 03:09clears you for treatment.
  • 03:11And you will head to the infusion area
  • 03:14during all steps of your infusion.
  • 03:16Nurses and pharmacists will use a
  • 03:19procedure called independent verification.
  • 03:20Independent verification can be
  • 03:22thought of as a double and triple
  • 03:25check on the treatment plan orders.
  • 03:27They're called independent because
  • 03:29two clinicians separately alone
  • 03:31an apart from each other,
  • 03:32check the instructions and
  • 03:34then compare results.
  • 03:35The results must match and make sense
  • 03:38in order to proceed with treatment.
  • 03:40This separation ensures that.
  • 03:42Each clinician thinks for themselves
  • 03:44and removes the opportunity for
  • 03:46another person to unintentionally
  • 03:48influence what they read or hear.
  • 03:50Two people are unlikely to make the same
  • 03:53mistake if they work independently.
  • 03:56You may be wondering why it is necessary
  • 03:59to double check the doctors orders.
  • 04:01Basically, these safety steps are
  • 04:04standards to prevent medication errors
  • 04:06that the American Society of clinical
  • 04:08oncology and the Oncology Nursing
  • 04:10Society require of all cancer centers.
  • 04:13And on Koleji practices,
  • 04:14there are three points at which
  • 04:16independent verification is required
  • 04:19prior to medication preparation
  • 04:21during medication preparation in
  • 04:23the pharmacy and right before
  • 04:25your medication is administered,
  • 04:27before your medication is prepared
  • 04:29in the pharmacy on each and
  • 04:32every day of your treatment,
  • 04:34two nurses in dependently double check
  • 04:36the orders entered by your Oncologist.
  • 04:39Note that in some circumstances
  • 04:42this may be a nurse.
  • 04:44And pharmacist,
  • 04:45the nurse that will be treating
  • 04:47you first checks that your weight
  • 04:49and height are accurate.
  • 04:50Reviews.
  • 04:50Results of your blood work and
  • 04:52assess is that you are not having
  • 04:55any side effects that would
  • 04:56prevent you from being treated.
  • 04:58Your treatment nurse then checks
  • 05:00that the medication dosages
  • 05:01are calculated correctly,
  • 05:02that the order includes the correct
  • 05:04administration root meaning,
  • 05:06for example by Ivy injection or pill.
  • 05:08The correct length of time and
  • 05:10the correct treatment date.
  • 05:11The nurse also checks if there
  • 05:13was any change in your dosage.
  • 05:16From your previous cycle of treatment,
  • 05:18if one was given a second nurse
  • 05:20independently checks all of the same
  • 05:23information when the check is completed,
  • 05:25the second nurse signs of
  • 05:27verification in the medical record
  • 05:29to attest that the order is correct.
  • 05:32If either nurse finds a difference
  • 05:34in what the Oncologist is ordered
  • 05:36or finds an incorrect order,
  • 05:38the nurse consult with the doctor
  • 05:40or oncology pharmacist.
  • 05:42Once this first verification is completed,
  • 05:44your order is sent or released
  • 05:46to the pharmacy for preparation.
  • 05:48The oncology pharmacy staff are
  • 05:50critical members of your cancer health
  • 05:53care team and oncology pharmacist
  • 05:55is an expert in medications used to
  • 05:58treat cancer and is an invaluable
  • 06:00resource to doctors and nurses.
  • 06:02The oncology pharmacist reviews
  • 06:04your medical record and checks
  • 06:06that the treatment plan chosen by
  • 06:08your primary oncologist is correct
  • 06:10for your diagnosis and stage.
  • 06:12They check that all of the
  • 06:14medications that you are currently
  • 06:16taking are compatible with the
  • 06:18treatment plan medications.
  • 06:20They also work with the business staff
  • 06:22to assure your cancer treatment plan is
  • 06:25approved or authorized by your insurance.
  • 06:28Working,
  • 06:28independent of the nurse,
  • 06:30the pharmacist performs the same
  • 06:32safety checks and dose calculations
  • 06:34that the nurse performed earlier.
  • 06:36The pharmacist also overseas the
  • 06:38activities of the pharmacy technicians
  • 06:40who are highly skilled in preparing
  • 06:42cancer treatment medications.
  • 06:44Once the pharmacist verifies
  • 06:45that the order is accurate,
  • 06:47the order is electronically sent to a
  • 06:50computerized Ivy com pounding system.
  • 06:52Called dose edge to spell out
  • 06:54the exact instructions for
  • 06:56the pharmacy technician to
  • 06:58prepare your medications.
  • 06:59Dose edge generates a label which
  • 07:01prompts the technician to gather
  • 07:03the ordered medications and needed
  • 07:05supplies like Ivy bag and tubing.
  • 07:08The supplies are passed into
  • 07:10the controlled environment.
  • 07:11Clean room through an air sealed window.
  • 07:14All medications are prepared in
  • 07:16the clean room using state of
  • 07:18the art equipment which is sure
  • 07:21the sterility of the medication.
  • 07:23And protects the pharmacy staff from
  • 07:25any leaks or fumes every step of the
  • 07:29preparation process is photographed and
  • 07:31bar coded to assure the right drug dose,
  • 07:34patient time and frequency
  • 07:36and administration route.
  • 07:37Also we have a record of every
  • 07:40step of the process.
  • 07:42Once prepared,
  • 07:42the medication is checked by the
  • 07:45pharmacist by reviewing all of
  • 07:47the photograph preparation steps.
  • 07:49Then a final dose label is
  • 07:51applied with the bar code.
  • 07:53That the nurse cans right before
  • 07:55administering your medication.
  • 07:57The whole pharmacy preparation process
  • 07:59usually takes from 30 to 90 minutes.
  • 08:01However,
  • 08:02this time frame may vary depending upon
  • 08:04the complexity of your treatment regimen.
  • 08:07You probably wonder why your medication
  • 08:09cannot be prepared ahead of time.
  • 08:11The answer is that as you go
  • 08:14through your cancer treatment,
  • 08:15your dose may need to be adjusted
  • 08:18or your treatment rescheduled.
  • 08:20If you experience any side effect or
  • 08:22change in your medical condition.
  • 08:25The 3rd and final independent
  • 08:26verification check is right before
  • 08:28your treatment is administered.
  • 08:29Your nurse will inform you that your
  • 08:32chemotherapy is ready to be given and
  • 08:34will ask you to turn off any electronics,
  • 08:37not use your phone or speak to
  • 08:39others with you during this check
  • 08:41so that you as a team member,
  • 08:44may participate fully in
  • 08:45the verification process.
  • 08:46You will be asked to state your first name,
  • 08:49spell your last name,
  • 08:50and tell us your date of birth.
  • 08:53Their nurse will tell you the name of
  • 08:55the medication you will be receiving.
  • 08:58And will describe what you may experience
  • 09:00during the infusion or injection.
  • 09:02Then your nurse will silently
  • 09:04check that the medication label
  • 09:07on the Ivy bag syringe or pill
  • 09:09matches the information in the
  • 09:11computer and your ID bracelet.
  • 09:13The nurse will program the pump
  • 09:15if needed for the infusion and
  • 09:17call in a second nurse to silently
  • 09:20perform the final independent check
  • 09:22of all of the same information
  • 09:25and pump settings as before.
  • 09:27If their check doesn't match.
  • 09:29Your nurse will notify the pharmacy
  • 09:31for clarification and Correction
  • 09:32before starting treatment.
  • 09:34We hope you found this video helpful
  • 09:36in answering some of your questions
  • 09:39and preparing you for what to expect.
  • 09:41We understand and appreciate that this
  • 09:44can be a challenging and sensitive
  • 09:46time for you and your family.
  • 09:48You can trust that all of us will do
  • 09:51everything we can to keep you safe
  • 09:53and comfortable during your chemo
  • 09:56therapy or immunotherapy treatment.
  • 09:58We thank you for choosing smilow.
  • 10:00Oncology for your treatment and we are
  • 10:03honored to be part of your health care team.