Advocate Children’s Hospital

Presentation Notes

Quality Improvement poster presented at Nursing Passion: Re-Igniting the Art & Science, Advocate Aurora Health Nursing & Research Conference 2022; November 9, 2022; virtual.


Background: At Advocate Children’s Hospital, patients receiving 28-day blinatumomab infusions needed to remain inpatient for the entire treatment.

Local problem: Local home health agencies were contacted, and only one was able to care for blinatumomab patients. Unfortunately, due to this being an investigational drug, there was no nursing agencies to provide this care.

Method: First, a rental home infusion pump vendor was identified. Next, a process was developed in partnership with our bi-campus outpatient hematology oncology clinics, inpatient hematology oncology units, pharmacies, and infusion pump vendor. Champion nurses were identified and trained on the equipment and supplies. Then, hands-on training was provided to the rest of the nurses. Resource packets were developed to support the inpatient/outpatient nursing teams.

Upon initial discharge from the hospital, families received a call from the infusion pump care manager to answer pump questions. A 24-hour help line was provided to the family to support pump troubleshooting. Patients went to clinic to change the infusion bags every 72 or 96 hours. The patients were first seen by a provider to evaluate blinatumomab tolerance and side effects. There was coordination between interdisciplinary teams to ensure that the patient had bag changes at the same time each visit.

Results/Conclusions: There were three patients on COG protocol AALL1731, randomized to the blinatumomab arm from May 2021-February 2022. A total of 150 (out of 168) days of blinatumomab infusions were completed outpatient utilizing the home infusion pumps.

Implications for practice: This was a huge satisfier to these patients and their families, as well as a cost-effective initiative, freeing inpatient beds for acutely ill patients and optimizing throughput. This quality improvement initiative was largely successful in allowing us to complete blinatumomab infusions at home.

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