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

QualityTool

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

Description

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

Developer:

American Society of Clinical Oncology

Funding Sources:

American Society of Clinical Oncology

History

Release Date: 2006
Original Summary: August 2006
Last Updated: 02/16/11

QualityTool Classification

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