Clinical Concerns Committee Meeting Minutes Date: June 20, 2011 Time:1400 hrs Location: 4E2.

24 Attendees: Regrets: 1. 2. 2.1 Shirley Perry, Karina Black, MaryAnne Venner, Erin Jonker, Mark Belletrutti, Marcel Romaniuk Agenda Items & Discussion Approval of Agenda Approved New Topics Codeine Survey # 1 Closed survey. 20 people participated. Most oncologists and clinic nurses but not may inpatient nurses. Plan to open survey again (Survey #2) the first two weeks of August. This will be discussed at July CCC with adapting survey #1 for the 2nd time point assessment. Previous Action Items IVAD placement concern: size and placement Shirley and outpatient nurses met with Dr. Evans with regards to IVAD size and placement and he will take it back to the other surgeons. Reminder to those asking for line insertions to ask for a large port with a placement higher up to facilitate access Physicians meeting report: Mark Belletrutti Specific Gravity: No objections from physicians. Blood work from clinic and then urine sample. Shirley will speak with Dr. Pinsk. We need to clarify details re: U/A (urine SG) plus serum osmo in clinic if normal, when to repeat / if needed, if delay in admission, how long would require repeat of baseline done in clinic. Serum osmo and U/A each time? would ideally be a prospective study to collect data moving forward vs retrospective analysis of clinical practice change given extra blood sample. Serology sheet: taking out Parvo otherwise fine. (Pre-chemo serology) Parvo would be added for Aplastic Anemia children. MaryAnne will look at the sheet to see if there are any other changes that are needed. Plan to have a template req. on inpatients/outpatients for reference to ensure everything needed is ordered for newly diagnosed patients. Shirley to check with

2.2 3. 3.1

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micro to see if a photocopy would suffice or do we need originally with reverse side completed. Fertility/Sexual Health for teens: We can proceed with what we want. Dr. Desai will act as MD of needed for any studies. Karina and Judy will take the lead on this project. Sexual health will be addressed, assess for needs (information/ resources/education). Blood cultures: Emergency will do what they do. Possibly will adjust the Pre-print. Proper technique for drawing the culture needs to be addressed (discard/flush prior), ?add to pre-print to draw from all lumens. LAsparaginaise monitoring is okay. Need to change wording of last point (MD/NP aware/available instead of present on unit as may be in vs outpatient). ?Add point to try not to give on weekends. Can be made official and posted. VZIG IV was dealt with. Possibly do a chart review to publish. Five cases at least are required need to track names and reassess numbers in ?November. PFOs on Echoes: Is there anything being done with this information? Aisha to follow up with Thrombosis (Massicotte) to see if there are any precautions, may need to also check with Cardiology. We will need to figure out where this needs to be recorded on chart for future reference? 4. 4.1 5. 6. Date of Next Meeting: July 18, 2011 room 4E2.24 Adjournment Additional Items