By Matthew Cyr
Connie Dinning, RN, BSN, BA
Chemotherapy Order Entry system administrator; was a direct-care
nurse for 20 years
What is COE?
It’s the Pediatric Chemotherapy Order Entry system, which
is a computer system for doctors to prescribe chemotherapy more
safely for oncology patients, and for nurses and pharmacists to
review and work with those orders. It was developed jointly by Children’s
and the Dana-Farber Cancer Institute.
How does it work?
The system identifies the patient’s treatment plan, and includes
a drug dictionary, order prescribing and template building capabilities.
The treatment plans are used for many types of cancer and chemo
regimens, and for pediatric patients of all ages. Patients on the
same treatment plan who are due to get the same chemo regimen will
have a standardized set of orders, which vary only by dosing for
patient size or age, or unique patient needs.
How does COE make chemo delivery safer?
It requires the necessary components of an order, does the math
and standardizes orders. There’s no ambiguity because treatment
plans are reviewed intensively by nursing, pharmacy and medicine
prior to being given to patients. The result is that orders can’t
get through without being complete and well thought out. COE allows
us to track the fact that there are fewer changes to chemotherapy
orders, which often translates into saving potential errors in patient
What do you do as the COE administrator?
I create templates for COE, test the system and troubleshoot clinical
and computer problems related to chemo orders. I also train new
COE users, and help determine the best content for the templates
and COE. I didn’t have a technical background when I took
the job six years ago, but I’ve learned a tremendous amount
about computers and how systems work.
What has surprised you about nursing?
I got into it because I wanted to work with patients and families,
but I’ve been surprised that there are a variety of opportunities
for growth and a lot of satisfaction in other roles. When this job
came around, they needed someone with clinical expertise and it
sounded like the type of work that might be interesting. I just
started a master’s degree program and can see how it’s
helpful to have a broader knowledge of systems and management. Working
with COE has made me much more interested in the broader level of
clinical care. It’s really created a nice career path.
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nursing at Children’s, contact Cindy Zilch in the Children’s
Hospital Trust at (617) 355-2416 or email@example.com.