Evaluation of a rapid hydration protocol: Safety and effectiveness.

Area of Science:

• Pediatric Oncology
• Clinical Pharmacy
• Patient Hydration Management

Background:

• The Children's Hospital of Eastern Ontario (CHEO) implemented a rapid hydration protocol.
• This protocol aimed to expedite pre-chemotherapy urine specific gravity and pH target achievement.
• Potential benefits include reduced time to chemotherapy and improved patient outcomes.

Purpose of the Study:

• To evaluate if a rapid hydration protocol shortens the time to chemotherapy administration.
• To assess if the protocol reduces time to chemotherapy during peak staffing.
• To determine if the rapid hydration protocol increases adverse effects.

Main Methods:

• Retrospective chart review of 116 hydration events in 25 patients.
• Inclusion criteria: cyclophosphamide, methotrexate, cisplatin, ifosfamide chemotherapy.
• Measured time to urine targets, chemotherapy administration, hospital stay, and dosing time relative to shift change.

Main Results:

• Rapid hydration protocol led to significantly shorter times to meet urine specific gravity (≤1.01) and pH (≥7) targets.
• Chemotherapy administration was initiated sooner with the rapid protocol.
• Shorter hospital stays and more frequent pre-shift-change chemotherapy administrations were observed.

Conclusions:

• Rapid hydration protocols decrease time to chemotherapy administration and shorten hospital stays.
• Earlier chemotherapy dosing during peak staffing may reduce errors.
• The rapid hydration protocol did not increase adverse events.