%0 Journal Article
%T Introduction of a dose
%A Aisling Collins
%A Caoimhe E O¡¯Leary
%A Fionnuala King
%A Martin C Henman
%J Journal of Oncology Pharmacy Practice
%@ 1477-092X
%D 2019
%R 10.1177/1078155217736376
%X The increasing incidence of cancer and the finite capacity of hospital aseptic compounding units pose a serious challenge to the provision of cancer care. Chemotherapy dose-banding is a method of rationalising parenteral chemotherapy dosing and supply, whereby patient-individualised doses are rounded to predetermined banded doses. The banded doses may be outsourced as stock items which increases the supply capacity of the aseptic compounding unit. Kotter¡¯s 8-step change management model was used to structure the implementation of dose-banding of 5-fluorouracil 46-h infusers on the haematology¨Concology day ward in St. James¡¯s Hospital, Dublin. The impact of dose-banding on local practice was assessed through pre- and post-implementation surveys of stakeholders. In-house surveys of pharmacy, medical and nursing staff identified a generally favourable attitude towards implementing changes in the parenteral chemotherapy supply system, with some resistance to change evident. Dose-banding of 5-fluorouracil 46-h infusers was implemented successfully on the haematology¨Concology day ward. Dose rationalisation and flexibility of re-allocation of standard banded doses between patients were the primary benefits of dose-banding found. Post-implementation surveys showed that clinical staff were in favour of adopting dose-banding into standard practice; however, they were cautious about the degree to which the results of this limited study would be translated into substantive benefits if dose-banding was adopted for all suitable preparations. The success of the implementation process and the favourable opinions of stakeholders shown in the post-implementation survey enabled the dose-banding service to be extended to a further nine drugs. Kotter¡¯s 8-step change management model was a useful tool for structuring this process change in St. James¡¯s Hospital
%K Dose-banding
%K 5-fluorouracil
%K change management
%K rationalisation
%U https://journals.sagepub.com/doi/full/10.1177/1078155217736376