Day of treatment tool

A bit about you

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* 1. A bit about you

Name

Job title

Place of work

State

Email address

Preferred mailing address

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* 2. Do you identify as any of the following (you may select more than one)

Aboriginal or Torres Strait Islander

Culturally and Linguistically Diverse

Regional

Rural

Remote

Far remote

N/A

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* 3. How many years experience have you had in oncology?

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* 4. Are you actively involved in developing, influencing and managing change in your organisation?

No

Yes, please describe

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* 5. Tell us a bit about the work you do

	Yes	No
Do you work in a chemotherapy day unit?	Do you work in a chemotherapy day unit? Yes	Do you work in a chemotherapy day unit? No
Are you actively involved in patient assessment pre-treatment?	Are you actively involved in patient assessment pre-treatment? Yes	Are you actively involved in patient assessment pre-treatment? No
Do you administer anti-cancer treatment?	Do you administer anti-cancer treatment? Yes	Do you administer anti-cancer treatment? No
Do you have knowledge of toxicities from anti-cancer treatment and management?	Do you have knowledge of toxicities from anti-cancer treatment and management? Yes	Do you have knowledge of toxicities from anti-cancer treatment and management? No
Do you grade anti-cancer toxicities?	Do you grade anti-cancer toxicities? Yes	Do you grade anti-cancer toxicities? No

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* 6. Outline your experience in the pre-treatment assessment of patients receiving systemic anti-cancer therapies.

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* 7. Outline your experience in the management of patients experiencing treatment-related toxicities

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* 8. What tools do you currently use to assess your patients pre-treatment?

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* 9. Do you know of any other tools used to assess patients pre-treatment? (if yes, please describe)

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* 10. What decision making process do you use to determine if your patients treatment is going ahead?

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* 11. How do you communicate this to the wider team and pharmacy?

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* 12. Are you aware of the 24-hour telephone triage toolkit

Yes

No