Clinical Concerns Committee (CCC) Minutes : July 20th Meeting.

Present: Shirley Perry, NP, Mary Anne Vennner, NP, Marcel Romanick, Pharm, Eileen Harris, NP, Dawn Forbes, CNE. Terms of Reference (TOR) discussed. Dawn will send a copy around for final review from CCC members before sending to Paul and Monica for final approval. Please return any comments to me by Once TOR approved, Dawn will post on 4E2/4E3 and invite an RN to represent their unit. Dissemination of meeting minutes will be done through posting minutes on 4E3/4E2, and then placed into a binder. They will be emailed to CCC members, nursing staff, PCM, UM, & pediatric oncology/hematology physicians. Minutes will also be accessible on G drive. Marcel will distribute to pharmacy staff if appropriate. Minutes will also be emailed to psycho-social team if appropriate by Dawn. Shirley will forward any recommended practice changes from CCC to Monica Whitehead and Paul Grundy for approval. Dawn will ask Cheryl Boulet to add CCC items to 4E3/4E2 ward meeting agendas.

Issues raised: Pharmacy are contemplating standardizing amounts of solution in IV bags in an effort to save time and money. Marcel will prepare a list with information on and bring to next CCC meeting. Elective Red Cell Exchange Transfusion for patients with Sickle Cell Disease will take place on 4E3 22nd July. This is the first time a procedure of this kind will take place outside of the PICU. Ward staff have expressed concern over the high placement of IVADs on some patients. They can be difficult to access and appear to move very easily. Dawn will post a list in 4E3 asking for more detailed feedback on specific complications/patient details etc so that we can further look at the problems arising before approaching oncologists/surgeons. Postitive pressure (flolink) devices have now been used by Homecare for the last 3-4 months. These caps have been changed after every blood draw despite Baxter stating they do not need to be changed after blood work if a 10ml flush of saline can be used. CNEs have met with Maria Goldberg and Monica Whitehead regarding our concerns of increased infection risk. Maria is looking into patient populations/frequency of cap changes etc from Homecare. Dawn will bring any updated information back to CCC meeting.

Next meeting= August 17th at 1400hrs in Shirleys office.