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POGO Satellite Manual

2.0 Scope of POGO Satellite Program

2.1 Principles of POGO Satellite Clinic Care

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The principles of the POGO Provincial Pediatric Oncology Satellite Program include:

  1. Referral of eligible children diagnosed with malignant disease from specialized childhood cancer programs to POGO Satellite Clinics for components of their cancer therapy and/or supportive care (see Section 2.2. Eligible Patients).
  2. Assessment, stabilization and (where appropriate) management of an ill child previously diagnosed with malignant disease, including the treatment of therapy complications and the delivery of selected chemotherapeutic agents, will occur in accordance with protocols and formal guidelines. All other aspects of the care of eligible children will occur in the tertiary hospital (specialized childhood cancer program) context only.
  3. Treatment of children according to protocols. Protocol assignment, as determined by the specialized childhood cancer program and its affiliations with collaborative cancer study groups, must be respected and any local constraints overcome. For patients on study, the drugs are to be given under the aegis of the specialized childhood cancer program and the relevant Research Ethics Board (REB).
  4. POGO Satellite Clinic activity (e.g., inpatient pediatric, ambulatory and emergency care) must be closely integrated and carried out or supervised by designated, prepared pediatric staff with an identified lead physician and designated alternative physician(s)/Nurse Practitioner(s). Such alternative individual(s) must have appropriate training.
  5. Availability of accessible, acceptable local emergency care by pediatric specialized providers.
  6. Availability of Association of Pediatric Hematology/Oncology Nurses (APHON)-certified nurses, who have completed the Pediatric Chemotherapy and Biotherapy Provider Program, to administer chemotherapy agents.
  7. Designated POGO Satellite Program funding supports the delivery of chemotherapy during weekday clinic hours. Delivery of infusional chemotherapy on statutory holidays and/or weekends is neither required nor expected.
  8. Central Venous Catheter (CVC) access is strongly suggested as a prerequisite for delivery of infusional chemotherapy in a POGO Satellite Clinic. Early communication between the specialized childhood cancer program and POGO Satellite Clinic, and agreement of the POGO Satellite Clinic upfront, is required prior to referral of a patient without CVC access, in particular for administration of agents known to be vesicants.
  9. Patients >18 years of age that continue to be followed in the specialized childhood cancer program: Staff-to-staff conversations between the specialized childhood cancer program and POGO Satellite Clinic are required to assess potential for ongoing access to POGO Satellite Clinic care for patients >18 years of age that continue to be followed in a specialized childhood cancer program. Parameters of care with respect to the type of care to be provided (ambulatory vs. emergency care) and potential for admission to adult care services are to be discussed and mutually agreed-upon upfront. Care of patients >18 years of age in a POGO Satellite Clinic is neither required nor expected.
  10. Care must be delivered according to specific guidance documents (see Section 3.0 Chemotherapy Administration).

This guidance was updated by Dr. Paul Gibson, Children’s Hospital, London Health Sciences Centre, 2015. POGO gratefully acknowledges the following members of the 2021 Scope of POGO Satellite Program Clinical Panel for their review and input regarding Section 2.0 Scope of POGO Satellite Program: Dr. Uzma Ahmed, Trillium Health Partners, Credit Valley Hospital; Dr. Sarah Alexander, The Hospital for Sick Children; Dr. Sarah Barker, Orillia Soldiers’ Memorial Hospital; Dr. Carolyn Hutzal, Medical Director, POGO Satellite Program, Grand River Hospital; Dr. Mohammad Jarrar, Windsor Regional Hospital; Dr. Donna Johnston, CHEO; Dr. Arif Manji, Southlake Regional Health Centre; Christina McCauley, POGO and The Hospital for Sick Children; Kirsty Morelli, Scarborough Health Network, Centenary Hospital; Dr. Sean Murray, Northeast Cancer Centre, Health Sciences North; and Dr. Alexandra Zorzi, Children’s Hospital, London Health Sciences Centre.

Disclaimer: Source Accuracy

You are welcome to download and save a local copy of this document in the Word and/or PDF formats provided. As the POGO Satellite Manual is subject to ongoing revisions and updates by POGO, we recommend you regularly check the online version posted at https://www.pogo.ca/satellite-manual/ to ensure you have the most up-to-date content. In the event of any inconsistency between the content of a local copy and the online version of the POGO Satellite Manual, the content of the online version shall be considered correct. Please see also the POGO Satellite Manual Disclaimer.

Record of Updates
Version NumberDate of EffectSummary of Revisions
112/12/2022Original version posted.
2.2 Eligible Patients
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In this Section

  • 1.1 History and Overview
  • 1.2 Acknowledgements
  • 1.3 Committees and Working Groups
  • 1.4 POGO Satellite Manual Disclaimer
  • 2.1 Principles of POGO Satellite Clinic Care
  • 2.2 Eligible Patients
    • 2.2.1 Children Eligible for Chemotherapy Administration in a POGO Satellite Clinic
    • 2.2.2 Children Eligible for the Management of Complications in a POGO Satellite Clinic
    • 2.2.3 Children Eligible for Supportive Care in a POGO Satellite Clinic
  • 2.3 Scope of POGO Satellite Clinic Practice
  • 2.4 Expanded POGO Satellite Clinic Practice
  • 3.1 Safe Handling, Administration and Disposal of Chemotherapy Agents
    • 3.1.1 Personal Protective Equipment
    • 3.1.2 Preparation, Transport and Storage
    • 3.1.3 Administration of IV Hazardous Drugs
    • 3.1.4 Administration of Oral Hazardous Drugs
    • 3.1.5 Disposal of Equipment/Personal Protective Equipment used to Administer Hazardous Drugs
    • 3.1.6 Safe Handling for Pharmacy
    • 3.1.7 References
  • 3.2 Accidental Exposure/Spills
  • 3.3 Extravasation Management
    • 3.3.1 Prevention and Management of Extravasations
    • 3.3.2 Antidotes and Treatments for Extravasation
    • 3.3.3 Sample Extravasation Documenting Tool
    • 3.3.4 References
  • 3.4 Injecting SC Medication Via an Insuflon
  • 3.5 Chemotherapy Administration Reference List
  • 3.6 Central Venous Catheter Care
  • 3.7 Chemotherapy Quick Reference
    • 3.7.1 Rapid Hydration
    • 3.7.2 Provider Guide: Prevention and Management of Irinotecan-Induced Diarrhea
    • 3.7.3 Capizzi Methotrexate
    • 3.7.4 Erwinia Asparaginase
  • 4.1 Management of Fever and Neutropenia
    • 4.1.1 Routine Order Sample Sheet
    • 4.1.2 Sample Fever Cards
    • 4.1.3 Criteria for low-risk designation. Risk categorization refers to risk of bacteremia and serious complications, including mortality.
  • 4.2 Pentamidine Administration
    • 4.2.1 Inhaled Pentamidine
    • 4.2.2 Intravenous Pentamidine
  • 4.3 Antiemetics
  • 4.4 Treatment of Varicella-Zoster Infections
  • 4.5 Immunization of Children with Cancer
  • 4.6 Transfusion
  • 4.7 Clinical Circumstances that Warrant Consultation with the Specialized Childhood Cancer Program
  • 5.1 Palliative Care Overview
  • 5.2 Communication
  • 5.3 Settings of Care
  • 5.4 Symptom Management
  • 5.5 End of Life
  • 5.6 When a Child Dies at the POGO Satellite Clinic
  • 5.7 Appendix: Sample Bereavement Materials
    • 5.7.1 Reconciling Your Grief
    • 5.7.2 Funeral Arrangement Checklist
    • 5.7.3 Helping Children Who Grieve
    • 5.7.4 Coping with the Holidays
    • 5.7.5 The Grief Experience
  • 5.8 References
  • 6.1 Goals and Objectives
  • 6.2 Participant Site Selection
    • 6.2.1 Tertiary Hospital Site Selection
    • 6.2.2 Community Hospital Site Selection
  • 6.3 POGO’s Roles
    • 6.3.1 PHIPA, Privacy and Research
  • 6.4 Funding
    • 6.4.1 Funding Support for Tertiary Hospital Activity
    • 6.4.2 Funding Support for Community Hospital Activity
  • 6.5 Infrastructure and Formal Requirements
    • 6.5.1 Specialized Childhood Cancer Program Partners’ Role in the POGO Satellite Program
    • 6.5.2 POGO Satellite Clinic Partners’ Role in the POGO Satellite Program
  • 7.1 Preamble
  • 7.2 Investigator Responsibilities
  • 7.3 Training Requirements
    • 7.3.1 General Training for Conduct of Research
    • 7.3.2 Protocol-Specific Training
  • 7.4 Research Activities That May Be Completed in POGO Satellite Clinics Under Supervision of DSI
  • 7.5 Research Activities to be Completed in Specialized Childhood Cancer Programs Only
  • 7.6 Recognition and Reporting of Adverse Events (AEs)
  • 7.7 Data Transfer
  • 7.8 Pharmacy Drug Accountability
  • 7.9 Site Inspections and Quality Assurance
  • 8.1 Pediatric Oncology Shared Care Initial Data Transfer Sheet
  • 9.1 POGO Satellite Clinic Preparedness Checklist
  • 9.2 POGO Satellite Clinic Quality Assurance Checklist
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