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Satellite Manual

2.3.2 Limitations on Satellite Practice

2.4 Advanced Satellite Practice

POGO recognizes the continuous evolution of the level of care of the satellite centres. Since the advent of the program, the number of satellite centres and the expertise of the health care professionals on site has significantly developed. In particular, there are multiple nurses at each site with APHON certification. There are also sites that now have fully trained pediatric oncologists staffing their clinics. It is conceivable, that these centres may in the future welcome the opportunity to offer their patients and families services not currently defined within the scope of what is considered ‘standard’ satellite care.

Framework:

  • Institutional senior management commitment to development of an advanced/optimal satellite program
    • Two trained pediatric oncologists, or potentially one pediatric oncologist and one nurse practitioner with specific training in pediatric oncology with protection of a proportion of their clinical time for oncology practice.
    • APHON certified nurses
    • Inpatient nursing skills appropriate to pediatric oncology
      • Care of central lines and supportive care
    • Pharmacy commitment
    • Multidisciplinary inter-professional team

Satellites that meet the above criteria wishing to add an ‘advanced’ feature to their programs must first obtain the support of their local clinical, nursing and pharmacy leadership. The satellite team must then make a formal request to the POGO Senior Clinical Program Manager and Medical Director for consideration. POGO will then be charged with striking an ad hoc panel of stakeholders to evaluate the proposal. Panel members may include oncologists, nurses and pharmacists from both satellites and tertiary centres and also specialists such as radiology or infectious disease experts, depending on the proposed activities.

If the new proposed activity is deemed appropriate by the panel, a Standard Operating Procedure (SOP) will be developed and posted as part of the Satellite Manual for reference. The SOP must contain a plan to allow for continuous assurance of quality and suitability. Of note, an approved ‘out of scope’ activity at one satellite would be approved at that particular satellite only. Other satellites wishing to add the same or similar activity their offered services must undergo the same review process. Newly created activities will be reviewed as part of the regular satellite manual review process for consideration of addition to the ‘standard’ satellite scope.

3.0 Chemotherapy Administration
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In this Section

  • 1.1 History & Overview
  • 1.2 Acknowledgements
  • 1.3 Committees and Working Groups
  • 1.4 Satellite Manual Disclaimer
  • 2.1 Principles of Satellite Care
  • 2.2 Eligible Patients
    • 2.2.1 Children Eligible for Chemotherapy Administration in a Satellite Centre
    • 2.2.2 Children Not Eligible for Chemotherapy Administration in a Satellite Centre
    • 2.2.3 Children Eligible for the Management of Complications on a Satellite Centre
    • 2.2.4 Eligibility of Children Requiring Supportive Care
  • 2.3 Scope of Satellite Practice
    • 2.3.1 Implementation of Psychosocial Treatment Plan (Process for Communication)
    • 2.3.2 Limitations on Satellite Practice
  • 2.4 Advanced Satellite Practice
  • 3.1 Safe Handling, Administration and Disposal of Chemotherapy Agents
  • 3.2 Accidental Exposure/Spills
  • 3.3 Extravasation Management
    • 3.3.1 Sample Extravasation Documenting Tool
  • 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 Document
    • 3.7.2 Provider Guide: Prevention and Management or Irinotecan induced Diarrhea
    • 3.7.3 Parent Handout: Prevention and Management of Irinotean induced diarrhea
    • 3.7.4 Capizzi Methotrexate
    • 3.7.5 Erwinia L-Asparaginase
  • 4.1 Management of Fever and Neutropenia
    • 4.1.1 Routine Order Sample Sheet
    • 4.1.2 Fever Cards (Sample)
    • 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 TPN Document
  • 4.6 Immunization of Children with Cancer
  • 4.7 Transfusion
  • 4.8 When to consult the Tertiary Centre
  • 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 in the Satellite Centre
    • 5.6.1 Reconciling your grief
    • 5.6.2 Funeral arrangement checklist
    • 5.6.3 Helping Children who grieve
    • 5.6.4 Coping with the Holidays
    • 5.6.5 The grieve experience
  • 6.1 Goals and Objectives
  • 6.2 Participant Site Selection
    • 6.2.1 Tertiary Site Selection
    • 6.2.2 Community Site Selection
  • 6.3 POGO’s Roles
    • 6.3.1 PHIPA, Privacy and Research
  • 6.4 Funding
    • 6.4.1 Funding Support for Tertiary Activity
    • 6.4.2 Financial Support for Pediatric Oncology Community Activity
  • 6.5 Infrastructure and Formal Requirements
    • 6.5.1 Tertiary Partners’ Role in Provincial Pediatric Oncology Satellite Program
    • 6.5.2 Satellite Partners’ Role in Provincial Pediatric Oncology 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 Activites that may be completed in satellite centres under supervision of DSI
  • 7.5 Research Activities to be completed in Tertiary Centres Only
  • 7.6 Recognition and Reporting of Adverse Events (AEs)
  • 7.7 Data Transfer
  • 7.8 Pharmacy Drug Accountibility
  • 7.9 Site Inspections and Quality Assurance
  • 8.1 Pediatric Oncology Shared Care Initial Data Transfer Sheet
  • 8.2 Shuttle Sheet
  • 8.3 Psychosocial Communication Tool
  • 9.1 Satellite Readiness/ Preparedness Checklist
  • 9.2 Education Report for Tertiary Centres
  • 9.3 Education Report for Satellite Centres
  • 9.4 Vital Signs Report
  • 9.5 Self- Assessment
  • 9.6 Satellite Contact Form
  • 9.7 Annual Satellite Caseload Report
  • 9.8 POGO Provincial Satellite Program Annual Accounting Report
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