Keeping you Safe During Treatment

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.