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Instituting Vincristine Minibag Administration: An Innovative Strategy Using Simulation to Enhance Chemotherapy
Nancy Corbitt1, Lisa Malick, Jennifer Nishioka
1University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland. Nancy Corbitt, BSN, RN, OCN®, CRNI®, has worked at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC) for 31 years. Her focus is caring for inpatients, with a special interest in hematologic malignancies. She teaches on multiple topics, including leukemia, lymphoma, safe chemotherapy administration, and oncologic emergencies. Lisa Malick, MS, RN, OCN®, is a nurse coordinator who leads education, quality improvement, and patient safety initiatives at the UMGCCC. She has extensive experience in caring for patients with hematologic malignancies, didactic and clinical teaching, clinical research, and staff development. Jennifer Nishioka, PharmD, BCOP, has 23 years of oncology experience. For the past 7 years, she has been a board-certified oncology pharmacist. During her career, she has worked in both inpatient and outpatient settings with adult and pediatric patients. For the past 5 years, her role at the UMGCCC has been as the oncology clinical manager for the cancer center's pharmacy, and as the bone marrow transplant clinical specialist. Ann Rigdon, MS, RN, OCN®, has 11 years of experience in oncology nursing. She was a clinical practice and education specialist at the UMGCCC at the time of this project. She has since relocated and continues to work in support of nursing education. Stephanie Szoch, BSN, RN, OCN®, is a senior clinical staff nurse at the UMGCCC. She has worked in hematology for 7 years and has focused her involvement in both clinical practice and chemotherapy safety. Peggy Torr, BSN, RN, OCN®, is an oncology nurse at the UMGCCC. She has practiced in the field of oncology in the inpatient setting since 1984, with a primary focus on hematologic malignancies. She has helped develop and teaches in the center's hospital-based oncology programs.
Abstract:
The first fatal incident of wrong-route administration of vinca alkaloids occurred in 1968. Initial recommendations for practice change occurred in 2005. In 2012, 54% of oncology treatment sites had changed their practice. The authors' institution has developed a safe, adaptable, and consistent process to prepare, deliver, and administer vinca alkaloids by means of a minibag delivery. A multidisciplinary team, including representatives from the nursing and pharmacy departments, reviewed the literature and developed all processes, including staff education. Minibag administration began in August 2015, and more than 2063 doses have been administered without any extravasations. To date, the simulation strategy for education is effective, and the delivery system is safe.
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