ABSTRACT
Blinatumomab has shown great potential for patients with chemotherapy-resistant B-cell acute lymphocytic leukemia. Blinatumomab's toxicity profile includes central nervous system toxicities, as well as cytokine release syndrome. Although neurological toxicities associated with blinatumomab are almost always reversible, early detection and intervention of these toxicities is vital to ensure that patients continue their full course of treatment. Guidelines for the preparation and administration of blinatumomab in both inpatient and outpatient settings, as well as a standardized neurological nursing assessment, were developed to ensure safe and effective administration of blinatumomab.
Subject(s)
Antibodies, Bispecific/therapeutic use , Antineoplastic Agents/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Humans , Immunotherapy/adverse effectsABSTRACT
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.
Subject(s)
Antineoplastic Agents/administration & dosage , Guidelines as Topic/standards , Medication Errors/prevention & control , Vincristine/administration & dosage , Health Personnel/education , Humans , Medical Oncology , Patient Safety , Simulation Training/methodsABSTRACT
Patients receiving high-dose cytarabine as part of their chemotherapy regimen have a chance of experiencing neurotoxicities. Prompt identification of signs and symptoms can greatly reduce the chance of patients sustaining permanent neurologic damage. This article describes the development and successful implementation of an evidence-based, standardized neurologic assessment and documentation tool that was evaluated using a clinical utility questionnaire and an adherence audit.
