title: Evaluation of quality improvement initiative in pediatric oncology: implementation of aggressive hydration protocol.
abstract: Our goal was to improve the efficiency of chemotherapy administration for pediatric oncology patients. We identified prechemotherapy hydration as the process that most often delayed chemotherapy administration. An aggressive hydration protocol, supported by fluid order sets, was developed for patients receiving planned chemotherapy. The mean interval from admission to achieving adequate hydration status was reduced significantly from 4.9 to 1.4 hours with a minor reduction in the time to initiate chemotherapy from 9.6 to 8.6 hours. Chemotherapy availability became the new rate-limiting process.
authors.affiliation: Department of Pediatrics, Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA. lfratin1@jhmi.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Fratino
authors.forename: Denise A
authors.initials: DA
authors.lastname: Daniel
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Cohen
authors.forename: Allen R
authors.initials: AR
authors.lastname: Chen
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D015142:Baltimore; D002648:Child; D002985:Clinical Protocols / Q000592:standards; D017598:Efficiency, Organizational; D005440:Fluid Therapy / Q000451:nursing* / Q000592:standards; D006801:Humans; D050316:Medical Order Entry Systems / Q000458:organization & administration*; D008510:Medication Systems, Hospital / Q000458:organization & administration; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D009859:Oncology Nursing / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D010371:Pediatric Nursing / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D017751:Safety Management / Q000458:organization & administration; D018709:Statistics, Nonparametric; D013996:Time and Motion Studies; D017749:Total Quality Management / Q000458:organization & administration*
chemical_list: D000970:Antineoplastic Agents