b'NURSING HIGHLIGHTS 2022OUTPATIENT COLLABORATION: Monoclonal Antibody TreatmentMelissa DevineRN, MSN, CNL I DIRECTOR WOMEN AND CHILDRENS SERVICES, CONCORD HOSPITAL - CONCORDJennifer Cutuli-LamoureauxRN, MSN I NURSE MANAGER AMBULATORY CARE CENTER, CONCORD HOSPITAL - CONCORD Sondra ChampagneRN, BSN, CEN I NURSE MANAGER INFUSION TREATMENT CENTER, CONCORD HOSPITAL - LACONIAConcord Hospital health system administered over 1,500 MAb treatments to patients in 2022.The use of monoclonal antibody infusion therapy for the treatmentand significant planning with the Emergency Department,of SARS-CoV-2 was an effective therapy Concord Hospital was ablePharmacy and Transfer Center, enabled ACC to provide over 550 to provide to patients in the community. Over the course of manyinfusions during the peak 2-month period. months, the administration and management of the therapyprogram proved to be a team sport. Nurse leaders from our PediatricDuring thistime, the nurse manager of ACC partnered with theUnit, ambulatory care center and infusion treatment center Infusion Treatment Center (ITC) of Concord Hospital - Laconiacollaborated on meeting the needs of the patients. with an intent and focus to offer another location for treatment of patients in the central NH region. The nurse manager of the ITCOn the Pediatric Unit, in collaboration with multiple stakeholders,coordinated the referrals, treatment orders, scheduling templates they transformed and redesigned care at a critical point during and established staffing to also support MAb treatments 7 days a the surge of COVID-19. Positive patients that met criteria to receive week, providing service to almost 350 patients. Impressively, the ITC a therapeutic COVID-19 treatment commonly known as a staff were creative to find ways to open access to patients needing Monoclonal Antibody Infusion (MAb), were able to receive theMAb infusions while supporting their routine infusion schedule. therapy on the Pediatrics Unit of Concord Hospital.The therapy is an infusion that aims to help minimize the risk for patients needingOnce both infusion sites were operating regular weekly schedules, future hospitalization from worsening symptoms of COVID-19. we saw an increase in primary care providers direct scheduling and Designing and implementing the MAb program occurred at a rapidordering the medication to be administered, which allowed patients pace. In order to treat patients during peak COVID-19 infections, the to avoid the Emergency Department. Patients traveled from north pediatric team quickly designed treatment management protocolsof the Franconia Notch, to the southern border of the state and from and processes. The program initially operated out of two roomsthe seacoast to Monadnock region. located on the Pediatric Unit, with capabilities of accommodating Throughout the COVID-19 surge and beyond, all three locations four infusion patients at a time. Each day a dedicated MAb nurse cared for the infusion patients. Emergency Department providersfor MAb treatment worked closely with the pharmacy teams, would help to fast-track these patients to the Pediatric Unit, and environmental services, transfer center and information remain in contact with patients and staff through the use of iPadstechnology as they responded to the evolving need of and teleconference. In total, the Pediatric Unit was able to provide patients in our communities. Nurses from many different infusion therapy to approximately 135 patients. Length of stay departments came together to be trained and support the times were reduced from an initial four hours to just over two hoursadministration of therapy and infusion care needs. with process optimization and medication time adjustments.With ongoing partnership, our two infusion centers supported and With a growing need and the likelihood of a longer-term locationsuccessfully administered nearly another 500 MAb doses to patients. for treatment, the process was re-located to using the establishedThe innovation, determination and leadership which started with outpatient Ambulatory Care Center (ACC) at Concord Hospital. Thethe Pediatric team and strongly grew with the infusion centers,Pediatric team transitioned care to the ACC team, a well-versed positioned Concord Hospital health system to serve the patientsteam at infusion therapy who designed a seven day access planin central New Hampshire with high quality care to avoid thewhich eventually was staffed to cover up to 16 patients for treatmentprogression of their COVID-19 illness. Opening the door toa day. The ACC team worked closely with providers to pre-schedulecollaborative care across the health system allowed us to serve the patients as well as accommodate some same day needs. ACCpatient population more efficiently and effectively. The two infusion worked to cover the daily MAb infusion needs while maintaining the sites continue to collaborate and evaluate further opportunities to departments routine outpatient procedures. Overall collaborationenhance patient access and satisfaction across the region.P E O P L E | I N T E G R A T I O N | T R A N S F O R M A T I O N27'