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RESEARCH CTL GENERIC INFUSION ORDERS	

Types:      Research Oncology Treatment, ONCOLOGY SUPPORTIVE CARE
Synonyms:  RESEARCH, COMMON, INFUSION, GENERIC, CTL INFUSION

Cycle 1	Repeat 1 time	Cycle length: 2 days	Day -1	Perform every 1 day x1			Research tolerance: -2/+2 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --		  	PULSE OXIMETRY	Interval: --	Occurrences: --		  	OK TO USE	Interval: --	Occurrences: --		  	ACCESS PORTACATH	Interval: --	Occurrences: --			Labs
☐	ABO/RH	Interval: --	Occurrences: --		☐	ADENOVIRUS BY PCR	Interval: --	Occurrences: --		☐	ALBUMIN LEVEL	Interval: --	Occurrences: --		☐	ALKALINE PHOSPHATASE	Interval: --	Occurrences: --		☐	ALT (SGPT)	Interval: --	Occurrences: --		☐	AST (SGOT)	Interval: --	Occurrences: --		☐	BAL CELL COUNT AND DIFFERENTIAL	Interval: --	Occurrences: --		☐	BILIRUBIN DIRECT	Interval: --	Occurrences: --		☐	TOTAL BILIRUBIN	Interval: --	Occurrences: --		☐	BK VIRUS BY PCR	Interval: --	Occurrences: --		☐	BLOOD PARASITE SCREEN	Interval: --	Occurrences: --		☐	B NATRIURETIC PEPTIDE	Interval: --	Occurrences: --		☐	BUN LEVEL	Interval: --	Occurrences: --		☐	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☐	CD 4 SUBSET	Interval: --	Occurrences: --		☐	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☐	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		☐	CREATININE LEVEL	Interval: --	Occurrences: --		☐	CYTOMEGALOVIRUS ANTIGEN	Interval: --	Occurrences: --		☐	CYTOMEGALOVIRUS, QUANTITATIVE PCR	Interval: --	Occurrences: --		☐	EPSTEIN BARR VIRUS (EBV) BY PCR	Interval: --	Occurrences: --		☐	ELECTROLYTE (CHEM4)	Interval: --	Occurrences: --		☐	FOLLICLE STIMULATING HORMONE	Interval: --	Occurrences: --		☐	GULF COAST SEROLOGY TEST	Interval: --	Occurrences: --		☐	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --		☐	HEPATIC FUNCTION PANEL	Interval: --	Occurrences: --		☐	HUMAN HERPESVIRUS 6, QUANTITATIVE PCR	Interval: --	Occurrences: --		☐	IMMUNOGLOBULIN A	Interval: --	Occurrences: --		☐	IMMUNOGLOBULIN G	Interval: --	Occurrences: --		☐	IMMUNOGLOBULIN M	Interval: --	Occurrences: --		☐	LDH	Interval: --	Occurrences: --		☐	LUTEINIZING HORMONE	Interval: --	Occurrences: --		☐	MAGNESIUM LEVEL	Interval: --	Occurrences: --		☐	MEASLES (RUBEOLA) ANTIBODY, IGG	Interval: --	Occurrences: --		☐	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		☐	PNEUMOCOCCAL ABS, IGG	Interval: --	Occurrences: --		☐	PROTEIN, TOTAL	Interval: --	Occurrences: --		☐	TOXOPLASMA IGM AB	Interval: --	Occurrences: --		☐	T3, FREE	Interval: --	Occurrences: --		☐	T4, FREE	Interval: --	Occurrences: --		☐	TB NK CELLS	Interval: --	Occurrences: --		☐	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		☐	TETANUS ANTIBODY, IGG	Interval: --	Occurrences: --		☐	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	For childbearing females only.
			Labs
☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --			Nursing Orders
  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	Research Coordinator:  Please schedule Required Studies.
				Day 0	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	(Include breath sounds) Pre-Infusion and During Infusion.  

Starting Post Infusion:  Monitor Every 30 minutes x 2, Then Every 1 hour x 3.  

(Total monitoring period Post Infusion is 4 hours).
		  	RESEARCH -  PULSE OXIMETRY	Interval: --	Occurrences: --	Comments:	Continuous Pulse Oximetry for Oxygen Saturation levels GREATER than 90% During, and at least 30 minutes Post-Infusion.
		  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --	Comments:	Start peripheral IV, if no central line. Use 3-way stopcock and tubing.
		  	RESEARCH - SUPPLIES/KIT TO BEDSIDE	Interval: --	Occurrences: --	Comments:	Must be at bedside prior to infusion: Oxygen and suction set up, normal saline flushes, red caps, and syringes with needles (1mL and 3 mL).
		  	RESEARCH - ASSESS	Interval: --	Occurrences: --	Comments:	Patient for immediate reactions: 1) Allergic reactions (anaphylaxis) 2) Decreased oxygenation (due to migration of lymphocytes to lungs).
			Labs
☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --		☐	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Hydration
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open			Pre-Medications
  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once for 1 dose			Offset: 0 Hours	Instructions:	Give 30 minutes prior to product administration.		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	once for 1 dose			Offset: 0 Hours	Instructions:	Give 30 minutes prior to product administration.			Nursing Orders
  	ONC NURSING COMMUNICATION 100	Interval: --	Occurrences: --	Comments:	Cells to be administered by physician (generally by syringe injection with 0.9% Normal Saline flush)

Verify cell dose and patient information on Component Infusion Form. Record infusion start and stop time on form and place in patient's medical record.

Clinic nurse to remain at bedside during the entire infusion

Ensure informed consent is obtained
			Emergency Medications
  	TRANSFUSION REACTION EVALUATION	Interval: Once	Occurrences: --	Comments:	Emergency Medications: Anaphylactic precautions: Keep medications at the bedside to administer per physician's orders.
		  	diphenhydrAMINE (BENADRYL) injection 50 mg	Dose: 50 mg	Route: intravenous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.		  	hydrocortisone sodium succinate (Solu-CORTEF) injection 250 mg	Dose: 250 mg	Route: intravenous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.		  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	once PRN	Start: S			Instructions:	Keep at the bedside to administer per physician's orders.			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.