Streamlining outpatient cisplatin therapy to meet the challenges of today

Abstract

Increasing numbers of patients are receiving full courses of cisplatin therapy in such outpatient settings as clinics, offices, day hospitals, or home. Outpatient cisplatin therapy is administered safely and effectively in the ambulatory environment. Outpatient therapy is about one third the cost of inpatient therapy and offers the patient significant benefits in terms of work, illness perception, tolerance of side effects, and family strain. As more patients receive cisplatin on an outpatient basis, it is imperative that new strategies be developed to help streamline care to accommodate the growing number of outpatients. This article reviews methods used in a variety of settings to provide quality care to larger numbers of patients. A critical factor to consider when developing new care methods is how to maintain the fine balance between efficient, effective, economical, and quality care. Keeping that balance may necessitate a lot of trials and false starts. Developing a comfortable environment for cisplatin infusion is a matter of creativity. It is not necessary to spend large sums of money to create an acceptable setting. Flow sheets, standardized teaching protocols, patient information guides, patient diaries, and standardized hydration, antiemetic, and therapy protocols are just a few of the approaches that have been used to streamline care. Becoming involved in oncology nurse groups, networks, or continuing education programs are excellent avenues to meeting people who are all working on methods to streamline and provide quality care. The three elements of a successful outpatient program for the administration of cisplatin include having a comfortable setting, a well-organized, experienced staff, and appropriate patient selection. Patients are an excellent source of ideas for improving the care that they receive. A questionnaire or focus session with patients and families may yield valuable insights for improving care. The challenges of health care today will hopefully be met with methods that greatly benefit the patient.