Clinical Concerns Committee Meeting Minutes Date: January 18, 2010 Time:1400 hrs Location: 4E2.

24 Attendees: Regrets: 1. 2. 2.1 2.2 2.3 2.4 2.5 2.6 Mark Belletrutti, Marcel Romaniuk, , Shirley Perry Eileen Harris, MaryAnne Venner, Dawn Forbes Agenda Items & Discussion Approval of Agenda Approved New Topics Blood draws accessing in the community Tabled but confirm with Dawn if it is case by case. CXR for blocked central lines: Should we have a protocol for blocked lines? When would an x-ray be indicated for a blocked line? Marcel will find papers on these guidelines, if available and then the papers will be taken to physicians for final decisions. Urine Q void or Q day Depends on issue and protocol. Clarification of issue where this enquiry came from. Needs further discussion. Shirley will check the orders she writes and bring it to Dawn and Mark for further discussion. IVAD/Broviac infection rate We had a run of infections and Dawn would like us to look into it. Surveillance study. Mark will check into this Double height/weight for patients receiving chemo Two nurses to sign off on the above. How often this would be done. The committee believes it will be a good idea. Mark will ask Calgary what they do for this. Consent for blood transfusions Yes, there should be consent for blood transfusions. There is the one of transfusion and the chronic transfusions. The chronic patient consent is reviewed every year. Consent should be done at the first transfusion. Dr. Nahirniak has a template for consent. Mark will talk to Dr. Nahirniak. Family Conference template There have been no comments to the contrary with template. Dawn go ahead and use the template. Previous Action Items

2.7 3.

3.1

3.2 3.3 3.4

4. 4.1 5. 6.

Chart label confusion with the surgeons: The surgeons are pulling any label thinking that they should be inpatient not realizing that we dont put those labels in the charts. If they wish inpatient they will need to request from inpatient if they are admitted post. Shirley has told the surgeons etc. that they need to be more observant with the labels. Resolved. Dose reductions. As per protocol. Rounding to m2: Has this been drawn up? Marcel has made recommendations and will modify and forward to Mark so that Mark can bring it to the physicians. Re: Scheduling of nuclear imaging (PET/CT or CT with a GFR) The concern was that if we ask for a PET/CT or CT (it is the issue of the CT contrast) and a GFR on the same visit or within a few days the GFR needs to be done prior to the PET/CT or CT because it can affect the GFR. However when they are booked the booking clerk does not know this, either we need to catch it or we get a phone call from nuc med saying the GFR cannot be done. There was also an issue with ultrasound refusing to do an ultrasound when the patient was injected for GFR first, as they were concerned with exposure the isotope that was injected so we need to call both departments for this to go ahead. Action: For complex bookings please contact Cory in Radiology 407-8843. Marsha the nurse educator is alsoDr. Maguire is prepared to come and do an in-service with regards to these scans if we would be interested. There are specific guidelines. Additional Items Date of Next Meeting: March 22, 2010 Adjournment