Related Experiment Videos

Evaluation of quality improvement initiative in pediatric oncology: implementation of aggressive hydration protocol

Lisa M Fratino1, Denise A Daniel, Kenneth J Cohen

  • 1Department of Pediatrics, Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA. lfratin1@jhmi.edu

Journal of Nursing Care Quality
|March 17, 2009
PubMed

Insights

Implementing an aggressive hydration protocol significantly reduced pre-chemotherapy delays in pediatric oncology. This enhanced efficiency in fluid administration streamlined patient care, making chemotherapy availability the new bottleneck.

Area of Science:

  • Pediatric Oncology
  • Clinical Pharmacy
  • Healthcare Administration

Background:

  • Chemotherapy administration in pediatric oncology is often delayed.
  • Pre-chemotherapy hydration is a frequent cause of these delays.
  • Optimizing hydration protocols can improve treatment efficiency.

Purpose of the Study:

  • To improve the efficiency of chemotherapy administration for pediatric oncology patients.
  • To reduce delays associated with pre-chemotherapy hydration.
  • To identify and address the rate-limiting steps in chemotherapy delivery.

Main Methods:

  • Developed an aggressive hydration protocol for pediatric patients receiving planned chemotherapy.
  • Implemented standardized fluid order sets to support the protocol.
  • Measured the interval from admission to adequate hydration and time to initiate chemotherapy.

Main Results:

  • The mean interval to achieve adequate hydration decreased significantly from 4.9 to 1.4 hours.
  • The time to initiate chemotherapy was reduced from 9.6 to 8.6 hours.
  • Chemotherapy availability emerged as the new rate-limiting factor.

Conclusions:

  • An aggressive hydration protocol effectively reduces pre-chemotherapy delays in pediatric oncology.
  • Standardized fluid order sets are crucial for protocol implementation.
  • Further improvements in chemotherapy logistics are needed to maximize treatment efficiency.

Related Concept Videos

Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...