Developing IEC Standard Practice Guidelines across Settings

Abstract

Topic Significance & Study Purpose/Background/Rationale In 2016, a Comprehensive Cancer Center opened an ambulatory cellular immunotherapy clinic, partnered with an inpatient facility for hospitalization. The center provides FDA Approved CAR T Cell therapies as well investigational immune effector cell (IEC) products under Phase I/II clinical trials. To optimize patient care, a multidisciplinary workgroup developed IEC specific standard of care guidelines. These standards facilitate alignment of care between sites and promotes collaboration between nurses and providers to enhance patient outcomes. Methods, Intervention, & Analysis A multidisciplinary workgroup of content experts, including medical providers, clinical pharmacists, and nursing leaders collaborated to define best practices for patients undergoing cellular immunotherapy using current literature and clinical experience. As nurses play an integral role in providing direct patient care and symptom recognition, their collaboration in the development of the standard processes was essential. The guidelines helped define nursing policies, such as a focused nursing assessment for Cytokine Release Syndrome (CRS) and Neurotoxicity. This has been coupled with CRS & Neurotoxicity orders to ensure prompt and comprehensive treatment. Utilizing comprehensive standards which encompass organizational training, policy development, and patient care orders, ensures best care for patients and better health outcomes. Findings & Interpretation Implementation of novel IEC treatments is a multidisciplinary effort, with nurses playing a pivotal role in direct patient assessment and recognition of life-threatening complications. Standardization of practice is imperative to the delivery of consistent and comprehensive care to patients receiving these treatments. Discussion & Implications Nurses are on the forefront of caring for patients receiving innovative IEC treatments. Implementation of standard guidelines of care for this unique patient population aligns practices and streamlines patient care. The rapid development of novel IEC therapies requires defined evidence-based care practices be implemented with concurrent guidelines mandatorily assessed and updated based on emerging scientific data. Clinical standardization for IEC science implementation assures consistent best patient outcomes.