Rituxan nurse:pt ratio

  1. Hi Onc Nurses!
    I'm a nursing student doing a teaching presentation on Rituxan nursing care. My clinicals are on an onc/med/surg unit where the nurse to pt ratio was 2:1 for pts receiving Rituxan for the first time but they have recently changed it to 3:1. I have been looking in the literature for anything on staffing recommendations but have come up short! Does anyone know anything about this issue that might be helpful?
    Thanks!
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  2. 12 Comments

  3. by   RNOCN2311
    Ummm, well from my experience in Rituxan, if it were me I'd want 2:1 or 1:1 if it was the first time infusion. I do not know of any specific quidelines or literature though.
  4. by   OCNshel
    Currently we don't have a documented policy on this, but we do try to lighten the load for a nurse giving first time Rituxan. Generally our patient load is 3:1-4:1.
  5. by   caroladybelle
    I have never seen any literature on it.

    It would be lovely to have a 2:1 ratio. But I have never seen that kind of ratio on an inpatient unit, other than the ICU level ones, where everyone was 2:1, or 3:1. The other patients were acute leukemics, getting ampho, blood, etc.

    Even on High dose IL-2 units, the ratio was 3:1 or more.
  6. by   EmmaG
    I worked on an oncology unit last year where the ratios were 6:1, 7:1 and 9:1 for days, evenings and nights. Regardless of patient acuity. I worked an evening shift where I had TWO patients receiving Rituxan, one first time, and another two getting chemo as well. (pushes)

    Insane.

    And my first-timer ended up with a reaction and going into symptomatic afib . The doc insisted I continue with the Rituxan and was pissed off when I refused.
  7. by   Transplant-BSNTx
    I work on an inpatient stem cell & bone marrow transplant unit where our ratios are 2:1 or 3:1 max. One nurse is only assigned one pt receiving Rituxan at a time with a 2:1 ratio. Our Rituxan infusion volumes are often 2 Liters each.
  8. by   nursemary9
    Hi

    Where I work--another med/surg;/hem/onc unit-- we get a set number of pt's also--weather we have chemo.s or not; I work nites & we get 5 or 6 pt's depending on the census not the accuity or weather they are getting chemo or not.
    I have had rituxin pt's along with a full compliment of 5 other pt's----BUSY, but what can you say---that's the staffing!!
  9. by   Lainee
    Quote from nursemary9
    Hi

    Where I work--another med/surg;/hem/onc unit-- we get a set number of pt's also--weather we have chemo.s or not; I work nites & we get 5 or 6 pt's depending on the census not the accuity or weather they are getting chemo or not.
    I have had rituxin pt's along with a full compliment of 5 other pt's----BUSY, but what can you say---that's the staffing!!
    same with my place.
  10. by   alarn
    hi, on my unit whether or not a pt is recieving chemo does not effect the nurse/pt ratio. ours is a 21 bed unit (usually, sometimes more depending on whether or not we have several empty positions) we sometimes get help from mgmt. w/chemo, but definitly not always. even w/ rituxan & some of your other more dangerous chemos, we still average approx. 6-7 pts. on days/nights, with MANY of these pts recieving blood about QOD (it seems) not to mention all of the abx, esp w/the neutropenic pts. and then there are the isolation pts (mrsa, cdiff and even vre) although nurses are not usually given both at the time. makes for extremely long days!!!! though they are usually so busy that they go by fast.
  11. by   RNview
    I would love to have 2:1 ratio for First induction of Rituxan. In our unit, we have 5:1 no matter what. This is crazy at times, especially when there's no charge nurse around to help out. It makes me want to cry sometimes. No matter how good I am with time management, things happen and you know the result of that. :redlight:
  12. by   RN007
    Quote from Emmanuel Goldstein
    I worked on an oncology unit last year where the ratios were 6:1, 7:1 and 9:1 for days, evenings and nights. Regardless of patient acuity. I worked an evening shift where I had TWO patients receiving Rituxan, one first time, and another two getting chemo as well. (pushes)
    Ditto where I used to work. That's why I left, sadly.
  13. by   julieK
    My answer will be a little different, since I don't work on an inpatient unit. I work in an outpatient infusion center, so our ratio doesn't really change with a Rituxan patient, first time or otherwise, b/c at any given moment we could be caring for a Rituxan, blood transfusion, first time taxane, or any other patient with high risk for reaction, but we always have 2-3 nurses monitoring about 10-11 patients who are in full view (and an additional 3 who are in bedrooms which are very close by). It's so much less stressful than on a regular floor where you can't really monitor your patients as closely.
  14. by   RNOCN2311
    I also work outpatient and we have 8 rooms and 4 nurses, we currently don't have "assignments" so, if everyone is on their game we get the 2:1 but yes we also could have a lot of other events going at once.

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