Refining Infusion Practice from the Front Lines Up

Published in Sibley Memorial Hospital Nursing Annual Report - Fiscal Year 2020

When something doesn’t work well for patients, clinical nurses are often the first ones to see it and say, “Maybe there’s a better way.” This is definitely true for Jessica Goggins, a nurse in the outpatient oncology unit who was looking critically at her infusion titration practice.

Rather than stop there though, Goggins and her manager, Katherine Evans, decided to look into it further. They found a promising approach for medication titration at the national Oncology Nursing Society Congress, and Goggins looked at how to integrate that workflow into her own practice administering infusions.

As soon as she started working with the approach, she found that “it immediately made sense for my patients.”

When Goggins pitched her idea for implementing the same evidence-based workflow and practice improvement for the whole unit to nursing leadership, she was surprised at how receptive they were. She was even more surprised at the buy-in from the oncology practice council—a multi-disciplinary group of hematology and oncology physicians, pharmacy leaders and other clinicians across the hospital.

“Everybody was in 100%,” she notes. That made a huge difference as they worked to modify the workflow to fit into the unit’s existing operating procedures.

The team rolled out the new workflow for infusions in early 2020 with a series of education and training sessions and it is now fully integrated into the unit’s infusion protocols.

While the process is still in its early stages, there have been very few bumps so far and all the unit nurses have bought into the new system. Although there are still more data to collect, patients and the entire nursing team are responding well to the new workflow, which has had an added bonus of streamlining infusion care by making the length of time for a patient’s infusion more standardized, too.

Goggins attributes this preliminary success to teamwork and leadership support.

“Everyone was receptive and made it so easy to push this forward,” she says. “I did not do this myself. Everybody—from the nursing team and leadership to the pharmacy team and everyone else in the hospital—rallied around this to help make it happen because it was best for our patients and our unit.”