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Journal articles on the topic 'Ambulatory oncology'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Overcash, Janine, Sandra Abels, H. Paige Erdeljac, Susan Fugett, Brittany Knauss, Elizabeth Kress, Cari Utendorf, and Anne M. Noonan. "Geriatric Oncology Ambulatory Care Clinics." Oncology Issues 33, no. 3 (May 4, 2018): 54–61. http://dx.doi.org/10.1080/10463356.2018.1456106.

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2

Cooley, Mary E., Esther Muscari Lin, and Susan W. Hunter. "The ambulatory oncology Nurse's role." Seminars in Oncology Nursing 10, no. 4 (November 1994): 245–53. http://dx.doi.org/10.1016/s0749-2081(05)80072-5.

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3

Weingart, Saul N., Angela Cleary, Andrew Seger, Terry K. Eng, Mark Saadeh, Anne Gross, and Lawrence N. Shulman. "Medication Reconciliation in Ambulatory Oncology." Joint Commission Journal on Quality and Patient Safety 33, no. 12 (December 2007): 750–57. http://dx.doi.org/10.1016/s1553-7250(07)33090-0.

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4

Lin, Esther Muscari, Jennifer L. Aikin, Wendy Bailey, Barbara Fitzgerald, Deborah Mings, Sandra Mitchell, and Barbara J. Rigby. "Improving ambulatory oncology nursing practice." Cancer Nursing 16, no. 1 (February 1993): 53???62. http://dx.doi.org/10.1097/00002820-199302000-00006.

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5

Gross, Anne, Susan Mann, Michael Kalfin, Sharon Lane, Saul Weingart, and Craig A. Bunnell. "Performance teamwork training in ambulatory oncology." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e16559-e16559. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e16559.

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e16559 Background: Increasingly complex diagnostic and multimodality treatment algorithms have yielded superior outcomes, but also magnified the risk for adverse events precipitated by failures of communication and coordination. We implemented team training principles in 14 outpatient oncology practices across 3 campuses (community and academic) to reduce the risk of errors and increase operational efficiency and quality. Methods: Over 950 physicians, nurses, pharmacists, and staff were trained in evidence-based concepts of teamwork. Intervention included 1) baseline data collection regarding key clinical processes, (e.g. non-communication of same-day chemotherapy order changes); 2) observations/interviews with care team members; 3) process meetings to identify vulnerabilities and develop agreements and tools to support them; 4) Train the Trainer methodology; 5) staff training; 6) post-training data collection. Results: Despite the infrequency of non-communicated same-day changes in chemotherapy orders at baseline (~2%), a trend toward improvement was seen (chi-square p=0.068). The incidence of missing chemotherapy orders for infusion visits not associated with an MD visit decreased significantly. Staff reported improved practice efficiencies and a more respectful, safer environment. Press Ganey patient-reported perceptions of teamwork improved significantly. Conclusions: Team training improved communication, task coordination, perceptions of efficiency, quality, safety and interactions among team members, as well as patient perception of teamwork in both community and academic environments of a comprehensive cancer center. [Table: see text]

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Martin, Virginia R. "Administrative issues in ambulatory oncology care." Seminars in Oncology Nursing 10, no. 4 (November 1994): 296–305. http://dx.doi.org/10.1016/s0749-2081(05)80077-4.

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7

Rapsilber, Lynn M., and Dawn Camp-Sorrell. "Ambulatory infusion pumps: Application to oncology." Seminars in Oncology Nursing 11, no. 3 (August 1995): 213–20. http://dx.doi.org/10.1016/s0749-2081(95)80031-x.

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8

Flannery, Marie, Shannon M. Phillips, and Catherine A. Lyons. "Examining Telephone Calls in Ambulatory Oncology." Journal of Oncology Practice 5, no. 2 (March 2009): 57–60. http://dx.doi.org/10.1200/jop.0922002.

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Purpose: A large component of ambulatory oncology practice is management of telephone calls placed to and from the practice between outpatient appointments. However, scant information is available in the literature concerning oncology practice telephone calls. The specific aims of this study were to define telephone call volume and distribution in an active ambulatory oncology practice, describe the callers and reasons for the telephone calls, and examine any differences in call volume by practice characteristics. Methods: A descriptive retrospective design was used to analyze medical oncology and hematology telephone calls in a 4-month period. Two investigator-developed tools were validated and used to collect data on telephone call content and patient demographics. Results: The sample included 5,283 telephone calls to or from 1,486 different individuals. Individuals making and/or receiving more than one telephone call in the study period represented 56% of the telephone calls. For every 10 scheduled clinic appointments, seven telephone calls were received or made. The volume of telephone calls was significantly higher on Mondays and in the mornings. The reasons for high-volume telephone calls by diagnosis and frequency were identified, with 30% of telephone calls involving multiple reasons. Conclusion: The data demonstrate the impact of telephone calls on ambulatory oncology practice and highlight the complex and highly variable actions required to manage the telephone calls. The findings confirm and document specific practice patterns and identify subgroups that target repeat telephone calls as an area for improvement.

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9

Maciejewski, Patricia R. "Oncology Nursing in the Ambulatory Setting." Gastroenterology Nursing 16, no. 5 (April 1994): 238. http://dx.doi.org/10.1097/00001610-199404000-00014.

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10

Milstone, Aaron, Aaron Milstone, Carol E. Rosenberg, Gayane Yenokyan, Danielle W. Koontz, and Marlene R. Miller. "1336. Alcohol Impregnated Caps and Ambulatory CLABSI: Multicenter Cluster Randomized, Crossover Trial." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S679. http://dx.doi.org/10.1093/ofid/ofaa439.1518.

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Abstract Background Central line-associated bloodstream infections (CLABSI) cause significant morbidity and mortality and occur more commonly in the ambulatory setting in pediatric oncology patients. Whether alcohol impregnated caps placed on central venous lines can prevent CLABSI in ambulatory pediatric oncology patients is unknown. Methods We performed a cluster-randomized, 2 period, crossover trial at 16 pediatric hematology/oncology clinics. Clinics were randomly assigned to usual ambulatory central line care per each institution (control) compared to use of 70% isopropyl alcohol-containing caps at home (intervention). Caps were only used in the ambulatory setting. The primary outcome was ambulatory CLABSI. Secondary outcomes included ambulatory mucosal barrier injury (MBI) CLABSI, secondary blood stream infections, single positive blood cultures, and positive blood cultures. Results Of the 16 participating clinics, 15 clinics completed both assignment periods. As assigned, there was no statistically significant reduction in incidence of ambulatory CLABSI in patients using 70% isopropyl alcohol-impregnated caps at home (1.23 per 1000 days, 95% CI 0.94, 1.60) compared with standard practices (1.38 per 1000 days, 95% CI 1.08, 1.77; adjusted incidence rate ratio [aIRR] 0.83, 95% CI 0.61, 1.12). There was no reduction in incidence of ambulatory MBI-CLABSI (aIRR 0.57, 95% CI 0.23, 1.40), single positive blood culture (aIRR 1.35, 95% CI 0.74, 2.48), or positive blood cultures (aIRR 0.80, 95% CI 0.60, 1.07). In the per protocol analysis, there was a reduction in incidence of positive blood cultures in ambulatory patients using 70% isopropyl alcohol-impregnated caps at home (1.51 per 1000 days, 95% CI 1.14, 2.00) compared with standard practices (1.88 per 1000 days, 1.47, 2.39; aIRR 0.72, 95% CI 0.51, 1.00). Conclusion Isopropyl alcohol- impregnated caps did not lead to a statistically significant reduction in CLABSI rates in ambulatory hematology/oncology patients, however, there was a reduction in positive blood cultures in the ambulatory setting in the per protocol analysis. Further research is needed to understand the clinical impact of alcohol-impregnated caps in the ambulatory setting. Disclosures All Authors: No reported disclosures

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Johnson, Amy, Lyle Fettig, Erin V. Newton, and Amber Comer. "Oncology fellows' current practice regarding concurrent outpatient oncology and palliative care." Journal of Clinical Oncology 36, no. 34_suppl (December 1, 2018): 122. http://dx.doi.org/10.1200/jco.2018.36.34_suppl.122.

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122 Background: It is accepted that Palliative Care provides additional support and improves overall care to oncology patients. Literature supports early referral and integration of Palliative Care with standard oncology care and is a guideline from the American Society of Clinical Oncology. In order to make palliative care integration a standard of care, Oncology Fellows should be learning to integrate during their fellowship years. There is little information regarding the Palliative Care experience in the outpatient setting for Oncology Fellows in the United States. This study looked at the current practice model in regards to concurrent Oncology and Palliative Care in the outpatient setting. Methods: An electronic nationwide survey of medical Oncology Fellows was conducted in the second half of the academic year in 2018. Results: 43 of 191, 22.5% Fellows contacted at 17 institutions responded. 98% of the fellows’ hospital systems offered ambulatory palliative care with 79% having a palliative care specialist available during their ambulatory Oncology clinic. 55% of the Fellows’ patient referrals are occurring when they still have multiple lines of cancer directed treatment planned, and the most common initial referral reason is for symptom management. 97% of fellows agree or strongly agree that it is appropriate to refer patients to ambulatory Palliative Care while patients are still undergoing active cancer treatment. 95% indicate they would strongly agree or agree with having a Palliative Care team in their future outpatient clinics. Although no participants stated their initial consult request was for psychosocial and/or spiritual support, 95% strongly agreed or agreed that Palliative Care helps ensure these issues are addressed. Conclusions: Early integration of Palliative Care is occurring in the 17 responding institutions around the country as 97% of Fellows agree or strongly agree that it is appropriate to refer patients to ambulatory Palliative Care while patients are still undergoing active cancer treatment. 95% of oncology fellows indicate they would strongly agree or agree with having a Palliative Care team in their future outpatient clinics.

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Mae Trinidad, PharmD, Denisse, and Puja R. Patel, PharmD, BCOP. "The Impact of an Embedded Oncology Pharmacist in an Outpatient Oncology Center in the Treatment of Hematologic Malignancies." Journal of the Advanced Practitioner in Oncology 13, no. 7 (September 1, 2022): 673–82. http://dx.doi.org/10.6004/jadpro.2022.13.7.3.

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Background: The growing demand for clinicians in the ambulatory oncology setting to reduce fragmentation of care and improve patient outcomes represents a need for oncology pharmacists as advanced practitioners in the provision of direct patient-centered care. These provisions can include supportive care management, drug-drug interaction evaluation, and selection of appropriate chemotherapy regimens to reduce physician workload in a cost-effective manner, while increasing physician and patient satisfaction. However, robust data are currently lacking to support the impact of pharmacists in the ambulatory oncology setting. The primary objective of this study is to justify the benefit of a full-time clinical pharmacist in the ambulatory oncology setting through documenting pharmacist-driven clinical interventions, correspondence of those interventions with cost avoidance, and perceived benefit from provider and patient satisfaction surveys. Methods: In this observational single-center pilot study, pharmacist interventions were documented and quantified from March 4, 2019, to March 9, 2021. This study evaluated the impact of these interventions through correlating cost avoidance and overall patient and provider satisfaction surveys regarding oncology pharmacists embedded in the outpatient clinic. Results: During the study period, a total of 545 diverse interventions were made by pharmacists. The estimated cost avoidance during the study period was $363,760, resulting in a net benefit of $753,150 per year. Both provider (n = 5) and patient (n = 8) surveys indicated strong agreement to the benefits of an oncology pharmacist’s involvement in clinic. Conclusion: This study demonstrates the clinical impact, financial benefit, and positive humanistic outcomes of an embedded oncology pharmacist within the ambulatory oncology setting.

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Nabhan, Chadi, and Sandeep Parsad. "Ambulatory Oncology Operations: Strategies to Alleviate Complexity." Journal of the National Comprehensive Cancer Network 14, no. 10 (October 2016): 1329–31. http://dx.doi.org/10.6004/jnccn.2016.0140.

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14

Hammelef, Karen J., Christopher R. Friese, Tara M. Breslin, Michelle Riba, and Susan M. Schneider. "Implementing Distress Management Guidelines in Ambulatory Oncology." Clinical Journal of Oncology Nursing 18, s1 (January 30, 2014): 31–36. http://dx.doi.org/10.1188/14.cjon.s1.31-36.

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15

Overcash, Janine. "Integrating Geriatrics Into Oncology Ambulatory Care Clinics." Clinical Journal of Oncology Nursing 19, no. 4 (August 1, 2015): E80—E86. http://dx.doi.org/10.1188/15.cjon.e80-e86.

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Friese, Christopher R., and Milisa Manojlovich. "Nurse-Physician Relationships in Ambulatory Oncology Settings." Journal of Nursing Scholarship 44, no. 3 (July 19, 2012): 258–65. http://dx.doi.org/10.1111/j.1547-5069.2012.01458.x.

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17

Ingram, Bethan. "Ambulatory care for haematology and oncology patients." British Journal of Nursing 26, no. 4 (February 23, 2017): S12—S14. http://dx.doi.org/10.12968/bjon.2017.26.4.s12.

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18

Conley, Susanne B., Joan O'Hanlon Curry, Melissa Hines, Kelley Baker, Kaye Schmidt, Kathy Zwier, Beth Siever, et al. "Consensus Statements: Ambulatory Pediatric Oncology Nursing Practice." Journal of Pediatric Oncology Nursing 27, no. 1 (November 6, 2009): 6–9. http://dx.doi.org/10.1177/1043454209344577.

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19

Walter, Jeanne M., and Susan H. Robinson. "Nursing care delivery models in ambulatory oncology." Seminars in Oncology Nursing 10, no. 4 (November 1994): 237–44. http://dx.doi.org/10.1016/s0749-2081(05)80071-3.

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20

Medvec, Barbara Ruppal. "Productivity and workload measurement in ambulatory oncology." Seminars in Oncology Nursing 10, no. 4 (November 1994): 288–95. http://dx.doi.org/10.1016/s0749-2081(05)80076-2.

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21

Philip, Beverly K. "Ambulatory anesthesia." Seminars in Surgical Oncology 6, no. 3 (1990): 177–83. http://dx.doi.org/10.1002/ssu.2980060309.

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22

Terry, Karen, Sophia Tsesmelis Piccolino, Alaysia Williams, and Cardinale B. Smith. "Integrating spiritual care into an ambulatory cancer center." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 205. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.205.

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205 Background: Spiritual care is identified as a core component of quality oncologic care. Unmet spiritual needs can lead to worse quality of life, lower satisfaction with care, and greater psychological distress. Despite increasing evidence that cancer outpatients also have unmet spiritual needs, professional spiritual care is often limited in the ambulatory setting. Many cancer centers provide access to professional chaplains only while patients are hospitalized. Where chaplain services are available to outpatients, access is often limited. At Mount Sinai, we embedded a full-time professional chaplain in our ambulatory cancer center. This presentation will describe our methods, results, and conclusions from a year of data on outpatient spiritual care referrals. Methods: We identified three sources of referrals to spiritual care: direct referrals from patients’ primary oncology teams, direct referrals from Supportive Oncology/Palliative Care, and automatic referrals through a question about meaning and purpose on our distress screen. We also included the opportunity for patients to self-refer to spiritual care through our distress screen. We collected data on the number of patients identified through these referral sources, time to initial contact, and the validity of the referral as assessed by our chaplain. Results: These three sources resulted in 454 referrals to spiritual care. We screened 1,410 patients through our distress screen and 16% (226) triggered a referral to spiritual care. Distress screen referrals comprised nearly 50% of all spiritual care referrals. In addition, 32% (144) of our referrals came from the patients’ clinical teams and 10% (46) from the Supportive Oncology team. Our chaplain assessed that 31% (141) had a spiritual need that required regular follow-up and 12% (56) required monitoring. Conclusions: Using multiple referral methods we were able to identify a significant number of ambulatory cancer patients with an identified spiritual need. Future projects will look at specific metrics for patient experience, improving chaplain ability to connect with patients, validating our screening question for spiritual distress, and determining an appropriate patient load for an outpatient chaplain.

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Au, Bianca, Deonne Dersch-Mills, Sunita Ghosh, Jennifer Jupp, Carole Chambers, Frances Cusano, and Melanie Danilak. "Implementation of additional prescribing authorization among oncology pharmacists in Alberta." Journal of Oncology Pharmacy Practice 25, no. 3 (January 16, 2018): 584–98. http://dx.doi.org/10.1177/1078155217752076.

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Purpose To describe the practice settings and prescribing practices of oncology pharmacists with additional prescribing authorization. Methods A descriptive, cross-sectional survey of all oncology pharmacists in Alberta was conducted using a web-based questionnaire over four weeks between March and April 2016. Pharmacists were identified from the Cancer Services Pharmacy Directory and leadership staff in Alberta Health Services. Descriptive statistics were used to describe the practice setting, prescribing practices, motivators to apply for additional prescribing authorization, and the facilitators and barriers of prescribing. Logistic regression was used to explore factors associated with having additional prescribing authorization. Results The overall response rate was 41% (71 of 175 pharmacists). Oncology pharmacists with additional prescribing authorization made up 38% of respondents. They primarily worked in urban, tertiary cancer centers, and practiced in ambulatory care. The top 3 clinical activities they participated in were medication reconciliation, medication counseling/education, and ambulatory patient assessment. Respondents thought additional prescribing authorization was most useful for ambulatory patient assessment and follow-up. Antiemetics were prescribed the most often. The median number of prescriptions written in an average week of clinical work was 5. Competence, self-confidence, and the potential impact on patient care/perceived impact on work environment were the strongest facilitators of prescribing. The strongest motivators to apply for additional prescribing authorization were relevancy to practice, the potential for increased efficiency, and advancing the profession. Conclusion The current majority of oncology pharmacist prescribing in Alberta occurs in ambulatory care with a large focus on antiemetic prescribing. Pharmacists found additional prescribing authorization most useful for ambulatory patient assessment and follow-up.

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Barysauskas, Constance, David G. Bundy, Aditya H. Gaur, Jeffrey D. Hord, Marlene R. Miller, Eric J. Werner, Cindi Winkle, and Amy Billett. "Burden of bloodstream infections among ambulatory pediatric hematology/oncology patients with a central line." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 262. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.262.

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262 Background: Pediatric hematology/oncology (PHO) patients are at high risk of bloodstream infections (BSI). The burden of BSI in PHO patients in the ambulatory setting has not been well documented. Methods: The Children’s Hospital Association leads the Childhood Cancer and Blood Disorders Network, a multicenter United States quality improvement collaborative, working to reduce the incidence of inpatient and ambulatory Central Line-Associated BSI (CLABSI) among PHO patients. Positive blood culture events (+BCE) were adjudicated as CLABSI, single positive blood cultures (SPBC) with potential commensals, or secondary BSI (attributed to source other than the central line) following standardized National Healthcare Safety Network definitions. Our study investigated the prevalence of +BCE among all centers with 90% complete monthly reporting of both +BCE and central line days (CLD) for at least one year (n=25) between January 2012 and September 2014. Ambulatory and inpatient BSI rates and 95% confidence intervals (CI) were calculated as the number of +BCE per 1,000 CLD per month. Results: A total of 1,747 +BCE and 4,883,413 CLD were reported among our target ambulatory population, whereas 1,095 +BCE and 353,259 CLD were reported among our corresponding inpatient population [Table]. While the CLABSI and SPBC rates were significantly lower in the ambulatory setting compared to inpatient (p<0.001), the total number of ambulatory CLABSI and SPBC events was 2.0 and 1.6 times higher than inpatient events, respectively. Conclusions: Our findings from a large multicenter collaborative demonstrate the burden of BSI among ambulatory PHO patients and identify benchmarks for future quality improvement work.Further investigation is necessary to develop effective infection reduction strategies for ambulatory PHO patients with central lines. [Table: see text]

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Gomes, Isabelle Pimentel, Paula Elaine Diniz dos Reis, and Neusa Collet. "Management of nursing’s care in pediatric ambulatory chemotherapy unit." Revista de Enfermagem UFPE on line 4, no. 2 (March 29, 2010): 510. http://dx.doi.org/10.5205/reuol.646-7074-1-le.0402201009.

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ABSTRACTObjective: to present the activities performed by oncology nurses in a pediatric chemotherapy unit of a university hospital. Methodology: experience report at a pediatric chemotherapy unit in a school-hospital. We searched for publications in electronic databases to support discussions. This study has been approved by the Research Ethics Committee of Hospital Universitário Lauro Wanderley (124/08). Results: the authors pointed out the importance of these professionals to rethink about their professional practice and of management of care a way to implement the required changes. The nursing assistance starts at the moment of patient into the room, with attention to welcome. The assistance is the main activity, the others, administrative, information system, education, scientific and humanization, promote the better care. In the scene of a room of chemotherapy of a school-hospital, the nurses need to use its technical, scientific, administrative and practical knowledge, regarding pediatric oncology, in order to carry out the management of the care. Conclusion: management of care directed to pediatric cancer patient must be dynamic, according the actual situation and each institution’s reality, using full clinical judgment, decision, reflection, integration, creativity and knowledge of specific issues of each patient. Descriptors: patient care management; nursing care; oncology nursing; pediatric nursing; management; chemotherapy; oncology service, hospital.RESUMOObjetivo: relatar as atividades do enfermeiro em ambulatório de quimioterapia pediátrica de um hospital escola. Metodologia: relato de experiência em ambulatório de quimioterapia pediátrica de um hospital escola. Buscaram-se publicações em bases de dados eletrônicas para subsidiar as discussões. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Universitário Lauro Wanderley (124/08). Resultados: a assistência de enfermagem inicia desde a recepção do paciente ao ser admitido, com o acolhimento. A assistência direta à criança é a atividade principal, as outras, administrativas, sistema de informação, educativas, científicas e humanização, favorecem o cuidado qualificado. No cenário da sala de quimioterapia de um hospital escola os enfermeiros precisam utilizar os seus conhecimentos técnico-científicos, administrativos e assistenciais específicos à oncologia pediátrica para realizar o gerenciamento do cuidado. Conclusão: o gerenciamento do cuidado de enfermagem direcionado à criança com câncer se beneficia quando é dinâmico e realizado de acordo com a situação vivenciada, com a realidade de cada instituição utilizando capacidade de julgamento, decisão, reflexão, integração, intencionalidade, criatividade e utilização de conhecimentos científicos específicos ao perfil da clientela. Descritores: administração dos cuidados ao paciente; cuidado de enfermagem; enfermagem oncológica; enfermagem pediátrica; gerência; quimioterapia; serviço hospitalar de oncologia.RESUMENObjetivo: presentar actividades del enfermero oncologista en ambulatorio de quimioterapia pediátrica de hospital escuela. Metodologia: informe de experiencia en ambulatorio quimioterapia pediátrica de un hospital de enseñanza. Se buscaron publicaciones en bases de datos electrónicas para apoyar las discusiones. El estudio fue aprobado por lo Comité Ética de Investigación del Hospital Universitário Lauro Wanderley (124/08). Resultados: la asistencia de enfermería inicia en lo momento en que lo paciente es admitido, acogiendo con atención. La asistencia es la actividad primordial, las otras, administración, sistema de la información, educación, científica y humanización, favorecen lo cuidado cualificado. En la sala de quimioterapia de un hospital escuela las enfermeras han de necesidad de utilizar sus conocimientos técnicos, la gestión y la atención específica a la oncología pediátrica para realizar la gestión de la atención. Conclusión: lo gerenciamiento del cuidado de enfermería direccionado a los niños con cáncer se beneficia cuando es dinámica, realizado conforme situación vivenciada, con la realidad de un servicio usando capacidad de juicio, decisión, reflexión, integración, intencionalidad, creatividad y utilización de conocimientos específico a lo perfil de los clientes. Descriptores: manejo de atención al paciente; atención de enfermería; enfermería oncológica; enfermería pediátrica; gerencia; quimioterapia; servicio de oncología en hospital.

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Manojlovich, Milisa, Louise Bedard, Jennifer J. Griggs, Michaella McBratnie, Kari Mendelsohn-Victor, and Christopher R. Friese. "Facilitators and Barriers to Recruiting Ambulatory Oncology Practices Into a Large Multisite Study: Mixed Methods Study." JMIR Cancer 6, no. 1 (April 20, 2020): e14476. http://dx.doi.org/10.2196/14476.

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Background Practice-based research is essential to generate the data necessary to understand outcomes in ambulatory oncology care. Although there is an increased interest in studying ambulatory oncology care, given the rising patient volumes and complexity in those settings, little guidance is available on how best to recruit ambulatory oncology practices for research. Objective This paper aimed to describe the facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study. Methods Using a mixed methods design, we sought to recruit 52 ambulatory oncology practices that have participated in a state-wide quality improvement collaborative for the quantitative phase. We used 4 domains of the Consolidated Framework for Implementation Research (CFIR) to describe facilitators and barriers to recruitment. Results We successfully recruited 28 of the 52 collaborative-affiliated practices, collecting survey data from 2223 patients and 297 clinicians. Intervention attributes included multimodal outreach and training activities to assure high fidelity to the data collection protocol. The implementation process was enhanced through interactive training and practice-assigned champions responsible for data collection. External context attributes that facilitated practice recruitment included partnership with a quality improvement collaborative and the inclusion of a staff member from the collaborative in our team. Key opinion leaders within each practice who could identify challenges to participation and propose flexible solutions represented internal context attributes. We also reported lessons learned during the recruitment process, which included navigating diverse approaches to human subjects protection policies and understanding that recruitment could be a negotiated process that took longer than anticipated, among others. Conclusions Our experience provides other researchers with challenges to anticipate and possible solutions for common issues. Using the CFIR as a guide, we identified numerous recruitment barriers and facilitators and devised strategies to enhance recruitment efforts. In conclusion, researchers and clinicians can partner effectively to design and implement research protocols that ultimately benefit patients who are increasingly seeking care in ambulatory practices.

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Stacey, Dawn, Debra Bakker, Esther Green, Margareth Zanchetta, and Michael Conlon. "Ambulatory oncology nursing telephone services: A provincial survey." Canadian Oncology Nursing Journal 17, no. 4 (2007): 1–5. http://dx.doi.org/10.5737/1181912x17415.

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28

Edwards, LaCrista, Kimberly Hermis, Christopher LeGette, Lourdes Lujan, and Cicely Scarlett. "Acuity-Based Scheduling: Outcomes in Ambulatory Oncology Centers." Clinical Journal of Oncology Nursing 21, no. 2 (March 17, 2017): 250–53. http://dx.doi.org/10.1188/17.cjon.250-253.

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29

Moody, Dana G. "External Ambulatory Infusion Devices and the Oncology Patient." Journal of Pharmacy Technology 2, no. 4 (July 1986): 160–65. http://dx.doi.org/10.1177/875512258600200406.

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30

Ireland, Anne M., Judith A. DePalma, Linda Arneson, Laurel Stark, and Judy Williamson. "The Oncology Nursing Society Ambulatory Office Nurse Survey." Oncology Nursing Forum 31, no. 6 (November 1, 2004): E147—E156. http://dx.doi.org/10.1188/04.onf.e147-e156.

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Friese, Christopher R., Mary Lou Siefert, Kaitlin Thomas-Frost, Stacy Walker, and Patricia Reid Ponte. "Using Data to Strengthen Ambulatory Oncology Nursing Practice." Cancer Nursing 39, no. 1 (2016): 74–79. http://dx.doi.org/10.1097/ncc.0000000000000240.

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Kamimura, Akiko, Karin Schneider, Cheryl S. Lee, Scott D. Crawford, and Christopher R. Friese. "Practice Environments of Nurses in Ambulatory Oncology Settings." Cancer Nursing 35, no. 1 (2012): E1—E7. http://dx.doi.org/10.1097/ncc.0b013e31820b6efa.

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Rinke, Michael L., Aaron M. Milstone, Allen R. Chen, Kara Mirski, David G. Bundy, Elizabeth Colantuoni, Miriana Pehar, Cynthia Herpst, and Marlene R. Miller. "Ambulatory pediatric oncology CLABSIs: Epidemiology and risk factors." Pediatric Blood & Cancer 60, no. 11 (July 23, 2013): 1882–89. http://dx.doi.org/10.1002/pbc.24677.

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Chackunkal, Ellen, Vishnuprabha Dhanapal Vogel, Meredith Grycki, and Diana Kostoff. "Improving adherence to the Epic Beacon ambulatory workflow." Journal of Oncology Pharmacy Practice 23, no. 4 (March 16, 2016): 273–77. http://dx.doi.org/10.1177/1078155216637215.

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Computerized physician order entry has been shown to significantly improve chemotherapy safety by reducing the number of prescribing errors. Epic's Beacon Oncology Information System of computerized physician order entry and electronic medication administration was implemented in Henry Ford Health System's ambulatory oncology infusion centers on 9 November 2013. Since that time, compliance to the infusion workflow had not been assessed. The objective of this study was to optimize the current workflow and improve the compliance to this workflow in the ambulatory oncology setting. This study was a retrospective, quasi-experimental study which analyzed the composite workflow compliance rate of patient encounters from 9 to 23 November 2014. Based on this analysis, an intervention was identified and implemented in February 2015 to improve workflow compliance. The primary endpoint was to compare the composite compliance rate to the Beacon workflow before and after a pharmacy-initiated intervention. The intervention, which was education of infusion center staff, was initiated by ambulatory-based, oncology pharmacists and implemented by a multi-disciplinary team of pharmacists and nurses. The composite compliance rate was then reassessed for patient encounters from 2 to 13 March 2015 in order to analyze the effects of the determined intervention on compliance. The initial analysis in November 2014 revealed a composite compliance rate of 38%, and data analysis after the intervention revealed a statistically significant increase in the composite compliance rate to 83% ( p < 0.001). This study supports a pharmacist-initiated educational intervention can improve compliance to an ambulatory, oncology infusion workflow.

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Patel, Mallika, Eric Lipp, Elizabeth Miller Patrick Healy, James Herndon, and Katherine Peters. "INNV-18. THE AVAILABILITY AND ROLE OF CLINICAL PHARMACISTS IN THE AMBULATORY NEURO-ONCOLOGY SETTING: AN INTERNATIONAL SURVEY." Neuro-Oncology 21, Supplement_6 (November 2019): vi134. http://dx.doi.org/10.1093/neuonc/noz175.561.

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Abstract BACKGROUND Outpatient clinics treating neuro-oncology patients are becoming more multidisciplinary. Utilization of all team members is critical for the holistic care of these complex patients. Specifically, the role of a clinical pharmacist in the ambulatory multidisciplinary clinic remains undefined and will likely evolve as more therapeutic options are developed to treat central nervous system malignancies. We queried the Society for Neuro-Oncology (SNO) membership about the availability of a clinical pharmacist in their ambulatory setting and, if present, the role of that clinical pharmacist. METHODS In an IRB exempt study, we surveyed the SNO community (targeting primarily clinicians) and analyzed responses to queries about clinical pharmacists in the ambulatory neuro-oncology setting. RESULTS Of the 65 SNO members who responded, 52 of these were clinical members. Of these 52 clinical members, the majority were physicians (88.5%, n=46). Of these 46 physicians, most were in academic practices (93.5%, n=43). Over half of the 52 clinical respondents (51.9%, n=27) reported that they saw ≥ 30 primary brain tumor patients a month, thus typifying busy clinical neuro-oncology ambulatory clinics. Despite having busy clinics, only 12 (28.6%) of the 42 providers with access to a clinical pharmacist reported that their clinical pharmacist was solely dedicated to neuro-oncology patients. For the respondents who had access to a clinical pharmacist, only 28 (66.7%) of those pharmacists had direct patient interaction in the clinic. The top three roles of the clinical pharmacist included medication review (81%, n=34), chemotherapy dosing and modifications (73.8%, n=31), and practice guideline development (61.9%, n=26), none of which are associated with direct patient interaction. CONCLUSIONS We found that while our surveyed population of SNO clinical members have demanding outpatient neuro-oncology practices, most do not have the support or expertise of dedicated neuro-oncology clinical pharmacists.

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de Lemos, Mário L., Carrie Kung, Victoria Kletas, Nadine Badry, and Isabell Kang. "Approach to initiating QT-prolonging oncology drugs in the ambulatory setting." Journal of Oncology Pharmacy Practice 25, no. 1 (January 3, 2018): 198–204. http://dx.doi.org/10.1177/1078155217748735.

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Since the introduction of regulatory drug approval guidance on the evaluation of QT interval prolongation, an increasing number of drug monographs has included cautions on the risk of QT prolongation. For example, QT prolongation is mentioned in the Canadian product monographs of 29 drugs commonly seen in oncology practice. This presents two major challenges. First, most guidelines and risk predictive tools for QT prolongation have been developed for hospitalized patients in acute care settings. In contrast, most QT-prolonging oncology drugs are used in medically stable patients in the ambulatory setting. Second, many oncology drugs are unique for their indications and non-QT prolonging alternative agents are often not available. In this review, we will outline an empiric initial approach to ambulatory cancer patients who are treated with oncology drugs which may prolong QT interval. This includes the predictive value of QT prolongation on torsades de pointes, the risk factors of the patients and the drugs, and the limitations of existing guidance in this area.

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Buswell, Lori A., Patricia Reid Ponte, and Lawrence N. Shulman. "Provider Practice Models in Ambulatory Oncology Practice: Analysis of Productivity, Revenue, and Provider and Patient Satisfaction." Journal of Oncology Practice 5, no. 4 (July 2009): 188–92. http://dx.doi.org/10.1200/jop.0942006.

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Physicians, nurse practitioners, and physician assistants often work in teams to deliver cancer care in ambulatory oncology practices. This is likely to become more prevalent as the demand for oncology services rises, and the number of providers increases only slightly.

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DeLisle, Julie. "Designing an Acuity Tool for an Ambulatory Oncology Setting." Clinical Journal of Oncology Nursing 13, no. 1 (January 1, 2009): 45–50. http://dx.doi.org/10.1188/09.cjon.45-50.

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Patel, Mallika P., Eric S. Lipp, Elizabeth S. Miller, Patrick N. Healy, James E. Herndon, and Katherine B. Peters. "Availability and role of clinical pharmacists in ambulatory neuro-oncology." Neuro-Oncology Practice 9, no. 1 (October 22, 2021): 18–23. http://dx.doi.org/10.1093/nop/npab060.

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Abstract Background Outpatient clinics treating neuro-oncology patients are becoming more multidisciplinary. Utilization of all team members is critical for the holistic care of these complex patients. Specifically, the role of clinical pharmacist (CP) in the ambulatory clinic remains undefined and will likely evolve as more therapeutics are developed for CNS malignancies. We queried the Society for Neuro-Oncology (SNO) membership about the availability of a CP in their ambulatory setting and, if present, the role of that CP. Methods In an IRB-exempt study, we surveyed the SNO community and analyzed responses to queries about CPs in the ambulatory setting. Results Of the 65 SNO members who responded, 52 were clinical members. Of these 52 clinicians, the majority were physicians (88.5%, n = 46). Of these physicians, most were in academic practices (93.5%, n = 43). Over half of the 52 clinical respondents (51.9%, n = 27) reported that they saw ≥30 primary brain tumor patients per month, thus typifying busy clinics. Despite having busy clinics, only 12 (28.6%) of 42 providers with access to a CP reported that their CP was solely dedicated to neuro-oncology patients. For the respondents who had access to a CP, only ~two-thirds of those CPs had direct patient interaction. The top 3 roles of the CP included medication review, chemotherapy dosing/modifications, and practice guideline development; none of which involve direct patient interaction. Conclusions We found that while our surveyed population of SNO clinical members have demanding outpatient practices, most do not have the support or expertise of dedicated neuro-oncology CPs.

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Jabaley, Terri, Janet Bagley, Brian Beardslee, and Marilyn J. Hammer. "Ambulatory Oncology Nurses Weigh in About 12-Hour Shifts." JONA: The Journal of Nursing Administration 52, no. 9 (September 2022): 491–97. http://dx.doi.org/10.1097/nna.0000000000001177.

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Afonso, Anoushka M., Patrick J. McCormick, Melissa J. Assel, Elizabeth Rieth, Kara Barnett, Hanae K. Tokita, Geema Masson, Vincent Laudone, Brett A. Simon, and Rebecca S. Twersky. "Enhanced Recovery Programs in an Ambulatory Surgical Oncology Center." Anesthesia & Analgesia 133, no. 6 (November 15, 2021): 1391–401. http://dx.doi.org/10.1213/ane.0000000000005356.

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Tishler, David, Erika Escobedo, Waseem Alhushki, Ashley S. Margol, Bhakti Mehta, and Teresa Rushing. "Influenza vaccine immunization in a pediatric oncology ambulatory practice." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 139. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.139.

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139 Backround: Complications from Influenza infection remain an important cause of morbidity and mortality among immunosuppressed children and adolescents. Seasonal Influenza vaccine has been shown to be both safe and effective in pediatric and adolescent patients on chemotherapy treatment although at the Childrens Center for Cancer and Blood Diseases (CCCBD), immunization rates remain suboptimal. We initiated a comprehensive campaign for the 2012-13 flu season with these objectives: 1) evaluate provider attitudes regarding Influenza vaccine, 2) provide a data capture form in the patient medical record to improve vaccine compliance and 3) retrieve electronic medical record (EMR) data on immunization incidence. Methods: The study period was October 1, 2012 through January 31, 2013; a hybrid hard copy/EMR was in use. A Survey Monkey questionnaire was given to CCCBD oncology providers to assess individual influenza vaccine practices. Information was provided how to document vaccination in the EMR. A reminder/data capture form was attached to the hard copy medical record and collected following each patient visit. Forms were tracked to ensure completion for each active oncology patient seen during the campaign period. Patient medical record numbers were cross-referenced with EMR data to determine immunization incidence and the success of the campaign. Results: 100% of providers (46/46) responded to the survey. All respondents believed that the flu vaccine was both safe and efficacious; many reported that the priority of oncology care pre-empted ordering vaccine (27%). Total vaccine doses dispensed increased by 28 % over the previous season (502 doses in 2012-13 vs. 361 doses in 2011-12). 61% of eligible patients with Acute Lymphoblastic Leukemia (ALL) were immunized in 2012-13 compared to 40% of ALL patients in 2011-12. EMR documentation of vaccination also improved during the campaign. Conclusions: A comprehensive campaign to promote Influenza immunization during the most recent flu season was overwhelmingly successful. In-progress improvement in the institutional EMR will further advance our ability to document and retrieve influenza vaccine data for this at-risk population of children and adolescents.

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Beddar, Sandra Mitchell, and Jennifer L. Aikin. "Continuity of care: A challenge for ambulatory oncology nursing." Seminars in Oncology Nursing 10, no. 4 (November 1994): 254–63. http://dx.doi.org/10.1016/s0749-2081(05)80073-7.

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Meyer, Fremonta L., Nicholas McCrory, Larissa Hewitt, and John R. Peteet. "Controversies Regarding Service Animals in the Ambulatory Oncology Setting." Journal of Oncology Practice 14, no. 3 (March 2018): 141–43. http://dx.doi.org/10.1200/jop.2017.026740.

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Siderov, Jim, Nan Wendel, and Ian D. Davis. "Non-Sedating Antihistamines for Premedication in Ambulatory Oncology Patients." Journal of Pharmacy Practice and Research 32, no. 2 (June 2002): 108–9. http://dx.doi.org/10.1002/jppr2002322108.

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Knox, Andrea. "Optimisation du rôle de l’infirmière spécialisée en oncologie dans l’unité de soins ambulatoires." Canadian Oncology Nursing Journal 30, no. 3 (July 16, 2020): 169–79. http://dx.doi.org/10.5737/23688076303169179.

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Dooley, William C. "Ambulatory breast cancer surgery." Annals of Surgical Oncology 7, no. 3 (April 2000): 174–75. http://dx.doi.org/10.1007/bf02523649.

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Seymour, M. T., and M. L. Slevin. "Ambulatory chemotherapy." Clinical Oncology 4, no. 1 (January 1992): 1–3. http://dx.doi.org/10.1016/s0936-6555(05)80758-7.

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Billett, Amy, Aditya H. Gaur, Eric J. Werner, Cindi Winkle, Jeffery D. Hord, Richard Brown, David Bundy, and Marlene R. Miller. "Moving prevention of central line associated bloodstream infection efforts beyond the hospital walls: A multicenter pediatric hematology/oncology collaborative." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 86. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.86.

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86 Background: Elimination of central-line (CL) associated blood stream infections (BSI) (CLABSI) in the inpatient setting has been a focus for many healthcare organizations. Little is known about the rate of CLABSI in the ambulatory setting or the optimal improvement strategies. We systematically expanded CLABSI prevention efforts for children with underlying pediatric hematology/oncology (PHO) disease from inpatient to ambulatory settings and describe the related process (definitions, improvement change packages, compliance assessment) and outcome measures (CLABSI and other BSI rates). Methods: The evidence-based CL care and maintenance bundles developed for the Children’s Hospital Association Quality Transformation Network PHO inpatient multisite collaborative were adapted for the ambulatory setting. Teams self-reported compliance with bundle elements (daily goals, line entry/dressing/ port needle/ tubing change processes) and submitted total CL days for the PHO cohort in their care. National Healthcare Safety Network (NHSN) defined CLABSI, secondary BSI (as per NHSN definitions), and single positive blood cultures (SPBC) (currently not captured by NHSN) were tracked. All process and outcome measures were collected using an online data entry system. Results: Prospective data collection and ambulatory bundle implementation began in Nov. 2011; to date 24 of 36 hospitals participating in the inpatient PHO CLABSI prevention collaborative have successfully implemented the ambulatory component to their program. As of May 2012, accrued data from the ambulatory setting exists for 214 ambulatory CLABSI, 30 secondary BSI, and 72 SPBC in patients with 719,637 CL in situ (not CL accessed) line days. To date self-reported compliance with bundle elements is > 80%. Conclusions: We demonstrate a successful multisite expansion of CLABSI prevention efforts to the ambulatory setting in PHO patients. Given the limitations of the current NHSN CLABSI definitions in the PHO population and the goal to reduce all BSI, not just CLABSI, we also propose tracking of secondary BSI and SPBC and discuss how this contextual information can be helpful.

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Rades, Dirk, Ahmed Al-Salool, Christian Staackmann, Florian Cremers, Jon Cacicedo, Darejan Lomidze, Barbara Segedin, et al. "A New Clinical Instrument for Estimating the Ambulatory Status after Irradiation for Malignant Spinal Cord Compression." Cancers 14, no. 15 (August 7, 2022): 3827. http://dx.doi.org/10.3390/cancers14153827.

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Estimating post-treatment ambulatory status can improve treatment personalization of patients irradiated for malignant spinal cord compression (MSCC). A new clinical score was developed from data of 283 patients treated with radiotherapy alone in prospective trials. Radiotherapy regimen, age, gender, tumor type, interval from tumor diagnosis to MSCC, number of affected vertebrae, other bone metastases, visceral metastases, time developing motor deficits, ambulatory status, performance score, sensory deficits, and sphincter dysfunction were evaluated. For factors with prognostic relevance in the multivariable logistic regression model after backward stepwise variable selection, scoring points were calculated (post-radiotherapy ambulatory rate in % divided by 10) and added for each patient. Four factors (primary tumor type, sensory deficits, sphincter dysfunction, ambulatory status) were used for the instrument that includes three prognostic groups (17–21, 22–31, and 32–37 points). Post-radiotherapy ambulatory rates were 10%, 65%, and 97%, respectively, and 2-year local control rates were 100%, 75%, and 88%, respectively. Positive predictive values to predict ambulatory and non-ambulatory status were 97% and 90% using the new score, and 98% and 79% using the previous instrument. The new score appeared more precise in predicting non-ambulatory status. Since patients with 32–37 points had high post-radiotherapy ambulatory and local control rates, they may not require surgery.

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