Recommended Citation
Nawaz H. Order-to-Needle: Coordinating Intrathecal Chemotherapy Administration. Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Abstract
Background/Significance:
Intrathecal (IT) chemotherapy is a complex, high-risk procedure involving administration of chemotherapy into cerebrospinal fluid. Errors in administration can result in significant morbidity or mortality. Since 1968, more than 69 documented cases of IT chemotherapy administration errors have been reported. However, the true incidence of errors is likely much higher due to under-reporting. To reduce risks, multiple healthcare professionals must be well-trained, adhere to protocol, and remain vigilant.
Purpose:
The objective of this project is to develop and implement a streamlined workflow for scheduling, preparation, and administration of IT chemotherapy. This workflow aims to establish effective communication to facilitate timely medication preparation, promote thorough documentation, and safe administration of IT chemotherapy.
Methods:
A retrospective chart review of adult IT chemotherapy administrations at Advocate Lutheran General Hospital was conducted from January 2024 through March 2025. Data focused on workflow and safety metrics, including dual authentication, barcode scanning compliance, and documentation in the medication administration record. Based on preliminary data, a standardized workflow was created to coordinate scheduling, preparation, and administration of IT chemotherapy. The workflow included secure interdepartmental communication, reinforcement of barcode scanning prior to administration, and real-time dual authentication. Primary outcomes included barcode scanning and dual authentication compliance; secondary outcomes included team satisfaction, documentation accuracy, and charge capture.
Results:
We retrospectively reviewed 118 patients–62 in the preliminary group and 56 in the post-implementation group. Barcode scanning compliance improved from 6.5% to 30%. Dual authentication compliance rose from 66% to 88%, reflecting improved real-time verification. Documentation and charge capture accuracy improved from 95% to 100% post-implementation.
Conclusion:
Implementation of a standardized workflow for intrathecal chemotherapy administration led to measurable improvements in safety and documentation practices. Barcode scanning and dual authentication increased notably, and documentation and charge capture accuracy reached 100% post-implementation. These findings support the effectiveness of a structured workflow enhancing patient safety and operational efficiency in intrathecal chemotherapy administration.
Presentation Notes
Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Full Text of Presentation
wf_yes
Document Type
Poster
Order-to-Needle: Coordinating Intrathecal Chemotherapy Administration
Background/Significance:
Intrathecal (IT) chemotherapy is a complex, high-risk procedure involving administration of chemotherapy into cerebrospinal fluid. Errors in administration can result in significant morbidity or mortality. Since 1968, more than 69 documented cases of IT chemotherapy administration errors have been reported. However, the true incidence of errors is likely much higher due to under-reporting. To reduce risks, multiple healthcare professionals must be well-trained, adhere to protocol, and remain vigilant.
Purpose:
The objective of this project is to develop and implement a streamlined workflow for scheduling, preparation, and administration of IT chemotherapy. This workflow aims to establish effective communication to facilitate timely medication preparation, promote thorough documentation, and safe administration of IT chemotherapy.
Methods:
A retrospective chart review of adult IT chemotherapy administrations at Advocate Lutheran General Hospital was conducted from January 2024 through March 2025. Data focused on workflow and safety metrics, including dual authentication, barcode scanning compliance, and documentation in the medication administration record. Based on preliminary data, a standardized workflow was created to coordinate scheduling, preparation, and administration of IT chemotherapy. The workflow included secure interdepartmental communication, reinforcement of barcode scanning prior to administration, and real-time dual authentication. Primary outcomes included barcode scanning and dual authentication compliance; secondary outcomes included team satisfaction, documentation accuracy, and charge capture.
Results:
We retrospectively reviewed 118 patients–62 in the preliminary group and 56 in the post-implementation group. Barcode scanning compliance improved from 6.5% to 30%. Dual authentication compliance rose from 66% to 88%, reflecting improved real-time verification. Documentation and charge capture accuracy improved from 95% to 100% post-implementation.
Conclusion:
Implementation of a standardized workflow for intrathecal chemotherapy administration led to measurable improvements in safety and documentation practices. Barcode scanning and dual authentication increased notably, and documentation and charge capture accuracy reached 100% post-implementation. These findings support the effectiveness of a structured workflow enhancing patient safety and operational efficiency in intrathecal chemotherapy administration.
Affiliations
Advocate Lutheran General Hospital