[RNOCN2311]

I shutter even typing the word.

For those in outpatient oncology, how is your department adjusting to the ever changing guidelines?

Our clinic basically treats everyone as Medicare....... and you know the hoops.


Of course, when they find something that works, they have to mess with it.

[oncnursemsn]

Was surfing the onc forum when I saw your post- I'm inpatient so I'm not sure. Are you referring to the guidelines re: Procrit changing to reflect a lower hgb? I guess with both our onc patients and chronic renal failure- if the hgb is in the higher (12gm) range, the incidence of cardiac complications increases. It's not a cheap drug, so that's the reason medicare is no longer reimbursing when the patient doesn't meet the criteria.
Being outpatient, how does this affect you?

[RNOCN2311]

Same, but Chemo induced can only be given for 8 weeks after the last chemo cycle and Hgb can't go past 10. CRF is 12, with labs monthly and every 2 weeks with a change..... etc. Our hospital had a "pay back" due to changes in payment guidelines so we have to rule out any other cause of anemia.

[me5115]

We joke and call it THE NUMBER OF THE DAY....we even posted it on the dry erase board. right now we are using 11.4 for renal less than 10 for chemo pts. and we have to check ferritin level every 3 months. We are giving a ton of blood transfusions now...
The procrit reb was layed off. We use mostly aranesp.

Has anyone seen and clotting issues in their practice with using these drugs?