(55) Bringing Blinatumomab to the Inpatient Oncology Unit

Title: Bringing Blinatumomab to the Inpatient Oncology Unit

Abstract : Boston Children’s Hospital (BCH) is in the unique position of caring for our pediatric oncology population across two institutions. This collaboration requires concise communication between BCH and Dana-Farber Cancer Institute (DFCI). The addition of Blinatumomab, a monoclonal antibody, to the treatment of CD19 positive ALL patients highlighted holes in this communication, IT capability, and readiness to educate nurses, patients, and families.

The purpose of this project was to ensure Blinatumomab in the Standard Treatment Plan (STP) was consistent amongst both institutions. We planned to increase understanding of systems, bedside care, collaboration amongst inpatient/outpatient settings, and the management of supplies and scheduling.

Our first step was initiating a Blinatumomab task force made up of administrative staff, attendings, nurse practitioners (NP), Epic IT specialists, pharmacists, educators, management, and bedside nurses from BCH and DFCI. We met weekly and created a to-do list that individuals worked on outside of the meetings. The bedside nurse liaison worked with the NP and educator to create a comprehensive document for bedside nurses, a Blinatumomab Standard Operating Procedure (SOP) for medical providers, and updated family education sheets. Epic support created a report to track incoming admissions to ensure availability of supplies and bed placements. We began our evaluation of systems with each patient that received the medication and the success from start to finish. Throughout this time there were changes to approved medication bag durations and IT systems.

Before the addition of Blinatumomab to the STP, the 6th floor saw 8-10 patients receiving this drug yearly. With the increased use, we are projected to treat 50-60 Blinatumomab patients in 2025. The qualitative data has proven positive in the successful admissions, preparation, administration, and safe discharge of these patients receiving a 28-day continuous infusion that is initiated at BCH and continues outpatient at DFCI.