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Palivizumab : a centralised clinic

Palivizumab : a centralised clinic. Laura Marshall RCN Conference 13 th March 2008. Pavilizumab. Initially marketed in the late 1990’s to prevent the incidence of RSV+ in under two’s. Due to lack of evidence and cost the JCVI made a tightened ‘at risk’ criteria for prescribing.

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Palivizumab : a centralised clinic

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  1. Palivizumab: a centralised clinic Laura Marshall RCN Conference 13th March 2008

  2. Pavilizumab • Initially marketed in the late 1990’s to prevent the incidence of RSV+ in under two’s. • Due to lack of evidence and cost the JCVI made a tightened ‘at risk’ criteria for prescribing. • Therefore by utilising these guideline a local protocol was implemented.

  3. Local criteria • Children under one year of age with chronic lung disease, receiving home oxygen therapy or prolonged oxygen use to a corrected gestational age of 36 weeks. • Infants less than six months of age with a haemodynamically significant left to right shunt.  Infants were selected at the discretion of the paediatric cardiologist • Children under two years of age with severe congenital immuno-deficiency. • Each child receives 5 doses (Oct-Feb) 15mg/kg of pavilizumab

  4. Historical Background • Prior to the centralised clinic babies were receiving individual home visits by a CCN per dose or attending an outpatient facility • Implications: • Time • Cost • Inability to vial share • In order to refine service delivery decided to pilot a centralised CCN led clinic

  5. Working Party • Working party set up in March 2006: • Lead CCN • Paediatric Pharmacist • Named Neonatologist • Named Paediatrician • Overall aim to not only to minimise waste and cost but to increase amount of treated children

  6. The clinic • One clinic a month (initially for 10 children) • Central location with parking • Allocated appointments • 90 minute clinic ran by two nurses • Vial sharing • Integrated care pathway • Patient held records

  7. Cost Analysis • 75 Nursing hours saved

  8. Evaluation • 100% attendance throughout season • Parent satisfaction questionnaire • Variance tracking • No children were admitted to hospital • Effective social support for families

  9. Season 2007/08 • 50 % increase in children • 100 % attendance • Suffolk PCT bought into the clinic for one patient.

  10. Conclusion • Nurse led services rapidly re shaping nursing services • Local CCNT provision varies • Communication between primary and secondary care paramount

  11. Questions? laura.marshall@chpct.nhs.uk jackie.acornely@cambridgeshirepct.nhs.uk

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