Implementation of an Emergency Department-Embedded Infusion Center for the Administration of Monoclonal Antibody Therapy in Patients With Early COVID-19 Infection

Julie Graham; Christina Ballejos; Danisha Jenkins; Christina Kelley

doi:10.1097/NAN.0000000000000453

Implementation of an Emergency Department-Embedded Infusion Center for the Administration of Monoclonal Antibody Therapy in Patients With Early COVID-19 Infection

J Infus Nurs. 2022 Jan-Feb;45(1):41-48. doi: 10.1097/NAN.0000000000000453.

Authors

Julie Graham^{1

2

3

4

5}, Christina Ballejos^{1

2

3

4

5}, Danisha Jenkins^{1

2

3

4

5}, Christina Kelley^{1

2

3

4

5}

Affiliations

¹ San Diego State University, San Diego, California (Dr Graham); Sharp HealthCare, San Diego, California (Drs Graham, Ballejos, and Jenkins); and Sharp Chula Vista Medical Center, Chula Vista, California (Dr Kelley).
² Julie Graham, PhD, APRN, ACCNS-AG, is a nurse scientist at San Diego State University and board-certified acute care clinical nurse specialist at Sharp HealthCare. Her doctoral and postdoctoral program of research is dedicated to oxygenation. She is also captain of Team OxygeNation, a group of nurse scientists and interdisciplinary collaborators dedicated to pulmonary critical care research.
³ Christina Ballejos, PhD, RN, CNS, is a clinical nurse specialist at Sharp HealthCare. She earned her bachelor's and master's degrees from Point Loma Nazarene University and her doctorate in from the University of San Diego. Her doctoral work was in the area of emergency nursing, with a focus on pain management in emergency department triage and emergency throughput.
⁴ Danisha Jenkins, PhD, RN, CCRN, NEA-BC, is a director of Critical Care, Emergency Services, and Advanced Illness Management at Sharp HealthCare. She is also a board member for the American Nurses Association Center for Ethics and Human Rights.
⁵ Christina Kelley, DNP, APRN, AGCNS-BC, NE-BC, NPD-BC, CNE, CCRN-K, is the director of education, research, and professional practice at Sharp Chula Vista Medical Center. In that role, she provides oversight to the clinical nurse specialists, senior specialists, and nurse educator teams in the form of clinical expertise that includes mentorship, professional development strategies, evidence integration, and innovative practices that guide the care delivered by the nursing workforce. Dr Kelley is also an agent for change who seeks to improve patient care outcomes and advance the nursing profession. Additionally, she guides the accreditation process for Magnet and Planetree designations. Outside of the clinical environment, Dr Kelley is an adjunct professor at Point Loma Nazarene University and Marsha Fuerst School of Nursing.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has tested nurse staffing and other resources necessary for lifesaving treatment. The emergency use authorization in November 2020 of bamlanivimab as monotherapy and casirivimab/imdevimab as combination therapy brought hope to many as an option for outpatients at risk for severe illness. However, logistical concerns were soon revealed, because safe administration requires a location where patients can receive specialized care and monitoring for a period of 2 hours. This type of therapy would normally be offered at an outpatient infusion center. These centers often serve persons who are immunocompromised, and introducing COVID-19-positive individuals could threaten the safety of this population. This article describes the deployment of an emergency department-embedded infusion center set up for the purpose of supporting community members and providers electing for this treatment option.

MeSH terms

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antibodies, Neutralizing
COVID-19*
Emergency Service, Hospital
Humans
SARS-CoV-2

Substances

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antibodies, Neutralizing
imdevimab
bamlanivimab
casirivimab