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Chemotherapy Measures What’s New?

Chemotherapy Measures What’s New?. Anne Hines Marie Brazil. General – DRAFT still. 1A’s – network board 1E’s – Network chemotherapy group 3’s – Cross cutting – 3S chemotherapy Numbering has changed 10 – 1E – 101s,102s etc 10 – 3S – 101,102 etc 100- chemotherapy service

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Chemotherapy Measures What’s New?

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  1. Chemotherapy MeasuresWhat’s New? Anne Hines Marie Brazil

  2. General – DRAFT still • 1A’s – network board • 1E’s – Network chemotherapy group • 3’s – Cross cutting – 3S chemotherapy • Numbering has changed 10 – 1E – 101s,102s etc 10 – 3S – 101,102 etc 100- chemotherapy service 200- oncology pharmacy 300 – intrathecal Note – no more stars – all important!! Pgs 11-13

  3. Nomenclature • Systemic chemotherapy im, oral, im, • Topical, intracavitary not included • Intrathecal – separate topic • Regimen – defined by the drugs used • Protocol – contains all the parameters specified in the measure • Algorithm – acceptible regimen or range of regimens which may be used for a stated site specific situation Pgs 15 -16

  4. Nomenclature cont • Course – complete period of treatment for a particular regimen • Cycle – repeated pattern over which the drugs are given

  5. 1A’s – Network Board • Old, 22 measures, New, 5 measures • Covers leadership of chemotherapy services at network and board level • Note that deliniation of chemotherapy services is now an acute onc measure

  6. 1E’s – Functions of Network Chemotherapy group • Old 12 measures, new 13 • Requires – annual review, work programme and annual report

  7. 1E’s -Treatment Algorithms Agree with NSSG a set of site specific chemotherapy algorithms – eg breast, haem, colorectal etc • Network Algorithm Deviation Policy • Network review of deviations Further clarity requested on definition of algorithm and how this fits with TYA measures – (no mention of algorithms)

  8. 1E’s – Error Reporting • The NCG should review the reported errors of the CCS’s and agreed remedial actions.

  9. 1E’s Training and Assessment policy • Network policy covering • Professional groups, activities needed to define process of chemotherapy, competency needed to work independently, • Network list of assessors • Named area of competence Networks appear to be being asked to maintain a current register of competent people – not feasible – should be done locally

  10. 3S’s – 1’s chemotherapy services • Old – 55 measures new- 35 measures • 10-3S-103 – named wards • 10-3S-104- specified room policy • 107 – defining chemo MPT • 111 – quality management system ? haematologist Not feasible in the time given if not already in place – no mention in NCAG or NCEPOD

  11. 3S’s - 1 con’t • 112 Error reporting – record and grade chemotherapy errors according to NPSA • 113 Further pre-treatment consultation with “sufficient” time between the previous for pt to digest the information • Patient pathway • Department timetable

  12. 3S’s - 1 con’t • 118 – agreed list of treatment algorithms • 119 – preventing regular deviation from the algorithm • Still need protocols as well – 120 • 127 – patient experience exercise • 128 – treatment plan to GP – regimen, startdate, planned duration, intent Protocols are not now network driven but locally driven

  13. 3S’s - 1 con’t • Chemotherapy dataset • - this measure will be included following implementation of the chemotherapy dataset in 2012

  14. 3S-2’s Oncology Pharmacy • 201 Lead pharmacist – single designated lead only • 204 But – also now need to list an aseptic lead • 206 – computer generated prescriptions • Note – no handwritten prescriptions is expected Further clarity on definitions of hand written etc requested as well as exceptions.

  15. 3S’s - 1 con’t • 207 – 209 – Electronic prescribing • SOP, variations, validation • Vinca alkaloids – correction requested for childrens services

  16. 10-3S-3 Intrathecal Chemotherapy (ITC) • Old 50 measures – new 22 measures • BUT • A lot have just been condensed eg – no major changes to requirements for ITC. • Lead, divisions, local protocol, register, risk assessment, hard copy of protocol, training competency assessors, who can administer, sequencing, labelling, prescription, collection, storage, room, normal working hours

  17. Don’t forget acute oncology!! 3Y’s • 1A – 302 – declaration of clinical chemotherapy services • 1A- 303 – declaration of oncology pharmacy services • 1A – 304 – review of services by network • 3S-122 policies relating to acute oncology • Extrav, anaphylaxis, NS, emesis, stomatitis mucositis and diarrhoea • Cross refs to 10-1E110y and 1E-107y • Still not sure if need network policies for all of these as well

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