MONTEFIORE MEDICAL CENTER

AMBULATORY ONCOLOGY INFUSION UNIT

SCHEDULING CONCERNS WITH NURSING STAFF

1. Appointment Times:
a. There are not enough appointments scheduled between 8:00am and 9:00am and
too many between 9:30 and 11:30.

Below is a breakdown of the schedule from May 18th (which has been a typical day)

Between 8:00 and 9:00 13 patients scheduled.

Between 9:30 and 11:30 43 patients scheduled.
Between 12:00 and 4:00pm 18 patients scheduled.

2. Time allotted for treatments:

a. Some treatments are not given the correct time needed when scheduled
IP chemo scheduled for 120 minutes. Should be 360 minutes.
Weekly Taxol scheduled for 60 minutes. Should be 180 minutes.
b. When designating a time frame for a particular treatment the following should be
considered:
Labs being drawn and processed
Reviewing orders
Assessing patient
Hooking the patient up to IV
New Patients orientation and teaching
Pre-meds and hydration given
Chemotherapy
Discharging the patient
c. If patient requires using an interpreter phone extra time is needed
Interpreter phones do not work on the A side. Pts that require an
interpreter needs to be seated on Bside.

3. Outside Doctors (Rheumatology / Dermatology):

a. These physicians should be aware of any policy or protocol changes
We had two patients today for Rituxan and the MD was not aware of the
new requirement to screen patients for HepB and HepC within the last
three months. This delayed the patients for approximately four hours.

4. Staffing:
a. As we know, nurses are out on maternity leave, medical leave, FMLA, vacations
ect. In addition, unfortunately someone may be out sick and this leaves unit in a
dangerous predicament.
b. Determine what is safe staffing for the infusion unit nurse Nurse to patient
ratio within a certain time frame
Additional Concerns:

1. Tech for Infusion Unit:

a. (Heather) We understood that the tech position was for the infusion unit. She is
seldom in the infusion unit. If she does float around a better time for her to help
out would be at 9:30 when the bulk of the patients are coming in. 3:00 is when
things are slowing down.

2. Supplies:
a. Frequently supplies get down to critical levels before delivery

3. Staffing:
a. When we had only 20 chairs we worked with 5 nurses. We now have 40 chairs
and most days work with 6 nurses.

4. Scheduling:
a. Why are nurses receiving five patients scheduled at the same time. (i.e. today
there are 22 patients scheduled for 10:00)
b. Give the patients that are scheduled later in the day to the 12 hour nurse.
c. Patients receiving IM injections should be scheduled on the A side for private
room.

5. Staff Meetings
a. Would like to have monthly staff meetings so that we can discuss any concerns

6. Study Patients / In-Services

a. A more formal meeting about new studies and staff in-services.
b. Staff would like to be informed ahead of time and not at the moment of the
meeting when patients are sitting in the waiting room.