A patient is suitable for referral to the day infusion service, if they meet the following criteria:

• patient is >16 years old
• patient is ambulant and continent
• patient is not currently an inpatient receiving treatment
• patient has not previously experienced a severe reaction to the prescribed treatment (i.e. requiring ICU admission).

Patients with an at-home carer are required to have the carer present during the treatment. Patients who require an interpreter or a liaison officer are eligible, provided they meet the above criteria.

Referrals outside the admission suitability criteria are considered at increased risk of inpatient admission and require a discussion between the CN, the MAPU consultant/medical officer and the referring speciality.

Iron infusion (non Heart failure or CKD patients)

• Hb <120g/L (female)
• Hb <130g/L (male)
• Serum ferritin <30ug/L

Target Hb is Hb 130 in female patients and Hb 150 in male patients.

Iron infusion in chronic heart failure patients

• NYHA II to IV functional class
• Beta blockage and ACE inhibition therapy instituted
• 6 monthly assessment of FBC and iron studies
• Hb <150g/L
• Ferritin <100ng/ml or Ferritin 100-300ng/ml with tSats<20%
• No contraindication for iron infusion

Iron infusion in CKD patients (end stage renal disease eGFR <60)

• (non-anaemic) tSats <20%, ferritin <100ng/ml with Hb >130g/L (male), >120g/L (female)  or
• (anaemic) tSats <30%, ferritin <55ng/ml with Hb <130g/L (male),<120g/L (female)

Other considerations

In the presence of inflammation with CRP >5, use transferrin saturation <20%, ferritin <100mg

Pregnancy

Iron infusion in pregnancy is facilitated in the Infusion clinic between 16 and 24 weeks.

Iron infusion is generally not indicated in the first trimester.

Patients 24 weeks+ may be referred to the Maternity Day Assessment Unit (MDAU) to facilitate infusion.

Referrals may be received from West Moreton Health and from outpatient speciality practitioners and general practitioners external to Ipswich Hospital.

Both internal and external referrals must include:

• contact details for the referring specialist/medical officer
• patient details including full name, date of birth and patient UR number
• type of appointment required and the duration of treatment plan
• treatment dose, route, frequency, and requirement for any pre-medications
• referral urgency
• the reason for the referral including relevant clinical details, patient medical/surgical history, allergies and investigations required prior to start of treatment and/or during as well as baseline and ongoing pathology screening
• iron infusion referrals are to include full blood count (FBC), Chemistry profile (ELFT), C-reactive protein (CRP) and iron studies as well as a recent weight to be able to effectively triage
• any medical or infectious alerts to be made known at time of referral.

All patient referrals must be accompanied by either:

• a PBS prescription (two pages) if appropriate, and sent to the Day Oncology pharmacist, or
• a complete medication order (including drug name, dose, route, and frequency) for ordering by the Day Infusion medical officer in ieMR.

The Pharmacy team will liaise with referring specialists regarding resupply of PBS prescriptions as required for continuation of treatment.

Once booked an electronic reminder will be sent to the patient one week prior and one day prior to the appointment scheduled.

Any booking changes must be made via the CN either by phone or email.

Internal referrals

To initiate treatment in the Day Infusion Service, the referring specialist/medical officer must complete a referral via:

• WM-Refer (preferred)
• sending complete referral and patient information via email to WM_infusionservice@health.qld.gov.au.

External referrals

To initiate treatment in the Day Infusion Service, the referring specialist/medical officer must complete a referral via Smart Referrals, sending complete referral and patient information via:

• emailing WM_infusionservice@health.qld.gov.au, or
• faxing to the priority fax line (07) 3810 1762.