POGO

icon-facebook

Satellite Manual

8.2 Shuttle Sheet

8.3 Psychosocial Communication Tool

The Psychosocial Communication Tool was developed to improve communication regarding psychosocial care issues at time of referral to the Satellite Centre.

Click here to download a copy of the Psychosocial Communication Tool.

Primary authors Ms. Lisa Egan-Bates, Southlake Regional Health Centre, Newmarket, Ms. Karen Fung, The Hospital for Sick Children, Toronto and Mr. Kaniska Young-Tai, The Hospital for Sick Children, Toronto. Reviewed by the POGO Satellite Manual Psychosocial Working Group, 2016.

9.0 Appendix 2: Reporting Formats
Back to Top

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
Back to table of contents
Search our Manual
Have a question?
Contact us at: satellite@pogo.ca
  • About Us
    • Diversity, Equity, Inclusion
    • Childhood Cancer Care Plan
    • Our Mission and Vision
    • Our Board
    • Our Partners
    • Our Donors
    • Privacy
    • History & Milestones
    • Reports
    • Newsroom
    • Job Opportunities
    • Accessibility
    • Staff List
  • Programs & Support
    • Patient Care Programs
    • Financial Assistance
    • Survivor Care
    • Cancer Resources
    • Childhood Cancer Resource Guide
    • Inspiring Stories
    • Clinical and Program Advisory Committees
  • Education
    • POGO AfterCare Education Day
    • POGO Multi-Disciplinary Symposium on Childhood Cancer
    • All Education Events & Conferences
  • Healthcare Practice
    • COVID-19 Updates
    • Pediatric Oncology Nursing
    • Clinical Practice Guidelines
    • Satellite Manual
  • Research & Data
    • 2020 POGO Surveillance Report
    • POGO Research Unit
    • POGONIS – Childhood Cancer Database
    • Data Reports
    • Data Requests
  • Get Involved
    • Pajamas and Pancakes
    • Birthday Parties for POGO
    • Events
    • Volunteer
  • Ways to Give
    • Donate
    • Gifts of Stock and Securities
    • Become a Corporate Partner
    • Gifts in Honour/Memory
    • Legacy Gifts
    • Shop Online/Earn Cash Back

©2020 Pediatric Oncology Group of Ontario

480 University Avenue, Suite 1014 | Toronto, Ontario, M5G 1V2, Canada | Charitable Registration Number: 871067245RR0001 | Contact Us
1-855-FOR POGO (367-7646) | Website Privacy Policy | Website Disclaimer | Satellite Manual Disclaimer |