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QualityTool Icon QualityTool:

White Blood Cell Growth Factors (CSF) Orders and Flow Sheet


square iconDescription

This flow sheet, derived from the 2006 update of an American Society of Clinical Oncology guideline, provides a tool for documenting the rationale and details for administration of white blood cell growth factors (colony-stimulating factors).

This flow sheet enables providers to record the following information:

  • Patient information
  • Justification for use
    • Primary administration (preventive)
    • Secondary administration (preventive)
    • Therapeutic use
    • Other clinical circumstance
  • Plan
  • Dose
  • Review and approval

Links to the Tool:
This tool is available at: http://jop.stateaffiliates-asco.org/July06Issue/Supp1.pdf (If you don't have the software to open this PDF, download free Adobe Acrobat Reader® software.)

Developer

American Society of Clinical Oncology

Funding Sources

American Society of Clinical Oncology


QualityTool Topic

Disease/Condition-Related; Guideline-Related; Quality Improvement Strategies


Links to National Guideline Clearinghouse or National Quality Measures Clearinghouse:

This tool is derived from the following guideline in the National Guideline Clearinghouse (NGC): 2006 Update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline:
http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=9419&string=

History

  • Release Date: 07/2006
  • Original Summary: 08/2006
Disclaimer: The inclusion of a tool in the Innovations Exchange does not constitute or imply an endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality or Westat of the tool or of the submitter or developer of the tool. Read more.
QualityTool Classification
Disease/Clinical Category: spacer Chemotherapy; Hematopoietic growth factor; Neutropenia, febrile
Patient Population: spacer Vulnerable Populations > Children; Frail elderly
Stage of Care: spacer Acute care
Patient Care Process: spacer Active Care Processes: Diagnosis and Treatment > Assessment; Medication: ordering, transcription, administration, dispensing; Care Management Processes > Coordination of care
IOM Domains of Quality: spacer Effectiveness
QualityTool Format: spacer Algorithm/Flowchart
QualityTool Topic: spacer Disease/Condition-Related; Guideline-Related; Quality Improvement Strategies
Developer: spacer American Society of Clinical Oncology
Funding Sources: spacer American Society of Clinical Oncology

 

Last updated: July 28, 2009.

 

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