assignments at infusion center

[bromford223]

Can anyone share how their nurse/patient assignment is done at their ambulatory infusion center? We recently opened a new 28 chair infusion center. We see about 40pts a day. Most receive chemo some blood and others abx. We are having difficulty with pts all arriving at same time although they are given scheduled appt times. The infusion center has four bays (pods)....we usually have six to seven nurses but it never seems to balance out with the workload..there has to be a better way!!!! thanks for any input.

[iluvivt, BSN, RN]

What we do is schedule our long infusions earlier in the day to get them going. These would include blood,IVIG,remicade and the like. Once you get them going it is then a matter of ramping their drugs up to tolerance and monitoring IV sites and monitoring for s/sx of hypersensitivity. The second problem you have is patients coming all at once. The key to making this work is how you schedule them and all RNs scheduling have to be on the same page. Before you make any appt estimate how long the entire visit will take and block out that time in that chair. so if you need 3 hours to infuse some IVIG....you put the pt in chair one and then block out chair one for 3 hours. you need a scheduling book that goes hr by hour so you can see at a glance how many pts you will have at any given time.

next you have to be very clear with patients about appt times,otherwise it can stress you out when they all arrive at the same time are seated and they are wondering why it is taking you so long. If a pt arrives to soon and you offer to seat them let them know they are early and they will have to wait. You can also ask pts to wait in a waiting room and return at their appt time. Do not feel bad about doing this....you need to control the work flow. The other thing you can do is to spread out the time consuming treatments throughout the week....you will have to play around a bit to find out what will work. For me chemotherapy can be intense and I do not like distractions. Is this is what you were looking for ?

[gardengirl63]

We do about the same thing. Schedule the long infusions and blood in the am and the antibiotics in the pm.We set up one area just for injections,aranesp,neupogen,neulasta and such quick in and outs.

We had the same problem of them all showing up whenever, in the old world with 6 chairs this was how it was done but now in the new world with 30 chairs we have to schedule appts and as iluvivt said we nicely remind them that they are early and we might be able to work them in..Sometimes someone might have another appt in town and we try to accomadate them. Our receptionist tells them up front that they are early but I will let the nurses know you are here. They all wait in the lobby. Even if they came for a blood draw and tx based on the results we send them to the lobby for the wait time.

[susing]

hi there , I also have a question and I also need advice. Im a new infusion center nurse , 4 months now , I just came from ICU in the same hospital where I was working for 3 years now. Anyway, I transferred because I have small children and infusion center as I know is like a clinic which opens at 6am and closes until 5pm. It was all good the first few months were seeing almost 60 patient's a day, there's 2 nurses and 1 PICC line nurse, which she do PICC all day and goes back for lunch. The following months were slow, from 60 our census went down to 40, and the department head decided that 1 nurse can handle 40 patient's a day. We dont do chemotherapy but bloods, remicade, iron's we do those. We complained already to the head because we feel unsafe having 6 blood transfusions a day and only one nurse running like a chicken , doing dressing change, access ports etc. Our head said that until the census reached up to 41 or more then they will let the other nurse come. Badly enough the nurse that I used to work with just fell last week because of trying to do all at once, and she was the first infusion nurse to work there, she's been there for 5 years.. I worked thursday and friday and I felt unsafe , having all this patient's and no help. I only have 1 license and I dont want to loose it. Im planning to go back to ICU. Please give me advice... thanks...

[zahryia, LPN]

Susing,

Run back to the ICU! This is an accident waiting to happen and the hospital WILL NOT have your back.

[Tolos]

Yes, I will run back to ICU or look for another infusion room job that do not operate in an unsafe manner. I do remicade, rituxan, actemra, steroids, orencia among other meds for the rheumatology dept of my clinic. I have maximum 13 patients a day when mixed with short timed infusions. The chemo nurses that come to fill up on thursdays because I go to another location, they complain and infuse maximum 8 patients.

[MALENURSE1974]

yes. run run run. i am in the same situation. i am the only nurse in my infusion center. i given everything except blood (for now). with me being the only person in the office that is CPR certified it scares the crap out of me. i have told them several time that i need help (especially since i have had 2 reactions recently). when i am tending to the patient having the reaction, there is NO WAY that i can get to my other patients. i have told upper managerment to stop looking at the numbers so much and look at the patients. i could have 6 people in the office at one time and nothing go wrong, but have 2 people in the office at the same time some day and a bad reaction happen and i can't watch this patient and mix there life saving drugs and do CPR at the same time.