Day infusion

The Day Infusion Service, located on level 7 Tower Block and situated within the Day Oncology Unit, is an outpatient service that provides:

  • intravenous administration of blood and blood products
  • intravenous administration of iron infusions
  • specialist drug infusions for chronic autoimmune conditions for Renal, Rheumatology, Neurology, Immunology, Dermatology and Gastroenterology patients
  • Bisphosphonate Infusion for Endocrine related conditions
  • collection point for some Subcutaneous Immunoglobulin consumables.

The unit is under the medical direction of the Medical Assessment and Planning Unit (MAPU) consultant, and the Day Oncology Nurse Unit Manager provides day-to-day operational and nursing staff support to ensure functionality and clinical safety of the unit.

The four-chair infusion unit works in collaboration with the MAPU Rapid Access Clinic to receive referrals, triage and treat accepted referrals. This outpatient model of patient care aims to reduce inpatient admissions, relieving pressure on surrounding hospital clinical services and improving patient satisfaction across the continuum of care.

Clinic bookings; blood product and consumables ordering; and nursing care delivery is led by a clinical nurse. The model of staffing is two registered nurses or a clinical nurse and registered nurse on a shift, with medical officer support on site during treatments.

Eligibility

A patient is suitable for referral to the day infusion service, if they meet the following criteria:

  • patient is >16 years old
  • patient is ambulant and continent
  • patient is not currently an inpatient receiving treatment
  • patient has not previously experienced a severe reaction to the prescribed treatment (i.e. requiring ICU admission).

Patients with an at-home carer are required to have the carer present during the treatment. Patients who require an interpreter or a liaison officer are eligible, provided they meet the above criteria.

Referrals outside the admission suitability criteria are considered at increased risk of inpatient admission and require a discussion between the CN, the MAPU consultant/medical officer and the referring speciality.

Inclusion criteria

Iron infusion (non Heart failure or CKD patients)

  • Hb <120g/L (female)
  • Hb <130g/L (male)
  • Serum ferritin <30ug/L

Target Hb is Hb 130 in female patients and Hb 150 in male patients.

Iron infusion in chronic heart failure patients

  • NYHA II to IV functional class
  • Beta blockage and ACE inhibition therapy instituted
  • 6 monthly assessment of FBC and iron studies
  • Hb <150g/L
  • Ferritin <100ng/ml or Ferritin 100-300ng/ml with tSats<20%
  • No contraindication for iron infusion

Iron infusion in CKD patients (end stage renal disease eGFR <60)

  • (non-anaemic) tSats <20%, ferritin <100ng/ml with Hb >130g/L (male), >120g/L (female)  or
  • (anaemic) tSats <30%, ferritin <55ng/ml with Hb <130g/L (male),<120g/L (female)

Other considerations

In the presence of inflammation with CRP >5, use transferrin saturation <20%, ferritin <100mg

Pregnancy

Iron infusion in pregnancy is facilitated in the Infusion clinic between 16 and 24 weeks.

Iron infusion is generally not indicated in the first trimester.

Patients 24 weeks+ may be referred to the Maternity Day Assessment Unit (MDAU) to facilitate infusion.

Referral pathway

Referrals may be received from West Moreton Health and from outpatient speciality practitioners and general practitioners external to Ipswich Hospital.

Both internal and external referrals must include:

  • contact details for the referring specialist/medical officer
  • patient details including full name, date of birth and patient UR number
  • type of appointment required and the duration of treatment plan
  • treatment dose, route, frequency, and requirement for any pre-medications
  • referral urgency
  • the reason for the referral including relevant clinical details, patient medical/surgical history, allergies and investigations required prior to start of treatment and/or during as well as baseline and ongoing pathology screening
  • iron infusion referrals are to include full blood count (FBC), Chemistry profile (ELFT), C-reactive protein (CRP) and iron studies as well as a recent weight to be able to effectively triage
  • any medical or infectious alerts to be made known at time of referral.

All patient referrals must be accompanied by either:

  • a PBS prescription (two pages) if appropriate, and sent to the Day Oncology pharmacist, or
  • a complete medication order (including drug name, dose, route, and frequency) for ordering by the Day Infusion medical officer in ieMR.

The Pharmacy team will liaise with referring specialists regarding resupply of PBS prescriptions as required for continuation of treatment.

Once booked an electronic reminder will be sent to the patient one week prior and one day prior to the appointment scheduled.

Any booking changes must be made via the CN either by phone or email.

Internal referrals

To initiate treatment in the Day Infusion Service, the referring specialist/medical officer must complete a referral via:

External referrals

To initiate treatment in the Day Infusion Service, the referring specialist/medical officer must complete a referral via Smart Referrals, sending complete referral and patient information via:

Contact information

Oncology administration team

Infusions RMO

  • Phone: (07) 3413 5866
  • Hours: 8.30 am–4 pm, Tuesdays-Thursdays and alternate Fridays