Sala de administración y observación
Número de salas disponibles para el tratamiento
Preparación del centro para el tratamiento con esketamina en pulverizador nasal
¿Cuál es el recorrido del paciente?
Fase de inducción
Dos sesiones por semana
Fase de mantenimiento
Una sesión por semana
Una sesión por semana o cada dos semanas
9+ semanas
Sesión de tratamiento estándar
Llegada al centro
Sala de espera
Consulta
Administración
El paciente se autoadministra este medicamento bajo la supervisión de un profesional sanitario.
Periodo de observación
El profesional sanitario vigilará al paciente hasta que esté clínicamente estable y se le considere listo para abandonar el centro sanitario
Salida del centro sanitario
¿Qué se necesita para la administración de este medicamento?
Silla/ sillón
Número total de sillas en estas salas
Tensiómetro
¿Dispone de un equipo para controlar la presión arterial?
Tiempo requerido del profesional sanitario
Número de profesionales de enfermería involucrados
¿Cómo optimizar la organización de recursos?
¿Cuánto tiempo se dedica al paciente?
sesión de tratamiento estándar
min
week(s)
min
min
Duración y frecuencia de tratamiento estándar
Duración del tratamiento en semanas
Número de semanas entre sesiones de tratamiento durante la fase de mantenimiento
¿Cuántos pacientes pueden ser atendidos en el centro?
Sala(s)
Sala(s)
Hora(s)/semana
Silla(s)/Sillón(es)
Enfermero(s)
Enfermero(s)
Hora(s)/semana
Tiempo dedicado a la observación
%
Aspiration of patients treated in a year
Número posible de pacientes por año:
Número de pacientes atendidos (sesiones) en una semana:
Numero de pacientes nuevos al mes
Impacto de añadir:
- h/s para las sala(s)
- h/w for enfermero(s):
- h/s para el médico:
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
L
M
X
J
V
S
D
lunes
martes
miércoles
jueves
viernes
sábado
domingo
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
C
N
P
S
C
N
P
S
C
N
P
S
C
N
P
S
C
N
P
S
C
N
P
S
C
N
P
S
1
2
3
4
5
Number of HCP's/rooms
Number of sessions
C Silla(s)/Sillón(es)
N Enfermero(s)
P Médico(s)
S Sessions
| lunes | martes | miércoles | jueves | viernes | sábado | domingo | ||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C | N | P | S | C | N | P | S | C | N | P | S | C | N | P | S | C | N | P | S | C | N | P | S | C | N | P | S | |
| 07:00 | ||||||||||||||||||||||||||||
| 08:00 | ||||||||||||||||||||||||||||
| 09:00 | ||||||||||||||||||||||||||||
| 10:00 | ||||||||||||||||||||||||||||
| 11:00 | ||||||||||||||||||||||||||||
| 12:00 | ||||||||||||||||||||||||||||
| 13:00 | ||||||||||||||||||||||||||||
| 14:00 | ||||||||||||||||||||||||||||
| 15:00 | ||||||||||||||||||||||||||||
| 16:00 | ||||||||||||||||||||||||||||
| 17:00 | ||||||||||||||||||||||||||||
| 18:00 | ||||||||||||||||||||||||||||
| 19:00 | ||||||||||||||||||||||||||||
| 20:00 | ||||||||||||||||||||||||||||
| 21:00 | ||||||||||||||||||||||||||||
| 22:00 | ||||||||||||||||||||||||||||
| 23:00 | ||||||||||||||||||||||||||||
|
1
2
3
4
5
|
Number of HCP's/rooms | Number of sessions | C Silla(s)/Sillón(es) | N Enfermero(s) | P Médico(s) | S Sessions | ||||||||||||||||||||||
What is the value for the site?
What are the priority drivers in site of care decision making?
What is the budget impact of implementing SPRAVATO® ?
Opportunity cost
Physician time dedicated to SPRAVATO®
hour(s)
Weekly working time
hour(s)
%
Nurse time dedicated to SPRAVATO®
hour(s)
Weekly working time
hour(s)
%
Room time dedicated to SPRAVATO®
hour(s)
Weekly available time
hour(s)
%
Out of pocket costs
| Total | Fixed costs 0€ |
Variable costs 0€ |
|
|---|---|---|---|
| € | € | ||
| € | € | ||
| € | € | ||
| € | € | ||
What are the options for funding SPRAVATO® ?
Reimbursement product
Preparación del centro para el tratamiento con esketamina en pulverizador nasal
Actions
Utilización de recursos y capacidad
Value
Información básica sobre la política de privacidad y disclaimer legal
Esta herramienta no recoge datos personales de sus usuarios. Los datos no personales recogidos para la provisión del servicio tienen como únicos propósitos el reporte y targeting interno. Los datos no personales recogidos pueden incluir, pero no están limitados a, datos de volumen del equipamiento, infraestructura, o profesionales sanitarios vs los requerimientos (por ejemplo: número de salas, sillas/sillones, existencia de equipamiento para la medición de la presión arterial, número de enfermeras en el servicio), horario de apertura del centro, número de horas disponibles de las salas, las enfermeras, tiempo dedicado a la administración y observación de esketamina en espray intranasal, estimación del tiempo de enfermería.
Referencias
Guía de usuario
Display
Show
Hide
Recorrido
¿Cuáles es el recorrido del paciente?
¿Qué se necesita para la administración de esketamina en espray intranasal?
Sala de administración y observación
Silla/ sillón
Monitor de la presión arterial
Tiempo requerido del profesional sanitario
Show
Hide
Utilización de recursos y capacidad
¿Cuánto tiempo se dedica al paciente?
¿Cuántos pacientes pueden ser atendidos en el centro?
Privacy Policy
This tool does not collect any personal data from its users. Non-personal data collected for the provision of services are solely for the purposes of internal reporting and targeting. Non-personal data which is being collected may include but is not limited to data on equipment / infrastructure / HCP volume vs. requirements (e.g. number of rooms, chairs, existence of blood pressure monitoring equipment, existence of safe storage space, number of physicians and nurses within the team); opening hours of site; volume of available hours for rooms, physicians and nurses; estimation of time spent on consultation, administration and monitoring for SPRAVATO® ; ‘expected number of patients’ to be treated with SPRAVATO® ; costs estimates (fixed and variable) of possible investment; working time estimate of physicians & nurses; status on recommendations, with possible answers being: already in place, to be done, not relevant; and an option to add own recommendation for improvement on infrastructure/capacity/value creation.
In some cases, we may also collect data obtained directly from you when you decide to communicate such data to us (e.g., your professional email address for us to send you the minutes of the discussion, or through open fields ‘notes’ and ‘actions to be taken’ per module). By using this application, you acknowledge that Johnson & Johnson will process the personal data you provide for the purpose of internal anonymized reporting and targeting. In such case, Johnson & Johnson will retain your data for as long as necessary for the provision of SoC Activation Tool services (e.g. email address is deleted after sending you the minutes by email). For more information, please read our Privacy Policy.
If you provide personal data concerning other individuals than yourselves you acknowledge that you have the right to provide such personal data, and that such individuals have been informed about, and agree to the processing of their personal data as per requirements in applicable data protection law. No data regarding personal patient information should be recorded via this tool.
Disclaimer
By using this Application, you are agreeing to be bound by the following terms and conditions.
The information on this Application is intended to furnish users with general information on matters that they may find to be of interest.
While every effort has been made to offer current and accurate information, errors can occur.
Furthermore, this Application may contain references to certain laws and regulations. Laws and regulations will change over time and should be interpreted only in light of particular circumstances.
JOHNSON & JOHNSON DISCLAIMS ALL LIABILITY AND RESPONSIBILITY FOR ANY ERRORS OR OMISSIONS IN THE CONTENT CONTAINED ON THIS APPLICATION.
All content on the Application and all services provided through it are provided “as is”, with no guarantees of completeness, accuracy or timeliness, and without representations, warranties or other contractual terms of any kind, express or implied.
Johnson & Johnson does not represent or warrant that this Application, the various services provided through this Application, and / or any information, software or other material downloaded from this Application, will be accurate, current, uninterrupted, error-free, omission-free or free of viruses or other harmful components.
TO THE FULLEST EXTENT PERMISSIBLE PURSUANT TO APPLICABLE LAW, JOHNSON & JOHNSON DISCLAIMS ALL LIABILITY TO YOU AND EVERYONE ELSE IN RESPECT OF THE CONTENT ON THIS APPLICATION AND ALL SERVICES PROVIDED THROUGH IT, WHETHER UNDER ANY THEORY OF TORT, CONTRACT, WARRANTY, STRICT LIABILITY OR NEGLIGENCE OR OTHERWISE, AND WHETHER IN RESPECT OF DIRECT, INDIRECT, CONSEQUENTIAL, SPECIAL, PUNITIVE OR SIMILAR DAMAGES, EVEN IF JOHNSON & JOHNSON WAS ADVISED, KNEW OR SHOULD HAVE KNOWN OF THE POSSIBILITY OF SUCH DAMAGES.
Johnson & Johnson reserves the right to alter or delete material from the application at any time, and Johnson & Johnson may, at any time, revise the terms and conditions, the legal disclaimer or other policies set forth in this application by updating it. Such modifications shall be deemed effective immediately upon posting on Johnson & Johnson’s application. Any continued use of the application shall be deemed conclusive of your acceptance of the modified terms and conditions, the legal disclaimer of Johnson & Johnson and other policies.
Información básica sobre la política de privacidad y disclaimer legal
Esta herramienta no recoge datos personales de sus usuarios. La recogida de información a través de esta herramienta tiene como único propósito ayudar a dimensionar la infraestructura y recursos necesarios en los centros sanitarios en relación con la administración y observación requeridas para Esketamina en pulverizador nasal. Los datos recogidos pueden incluir pero no están limitados a: equipamiento disponible, medios e instalaciones, o número de profesionales sanitarios vs. requerimientos de infraestructura (tales como número de salas, sillas/sillones, existencia de equipamiento para la medición de la presión arterial, número de enfermeras en el servicio, etc.), horario de apertura del centro, número de horas disponibles en las salas, número de enfermeras, estimación del tiempo de enfermería, entre otros. La recogida de información a través de esta herramienta no tiene finalidad promocional ni condiciona la toma de decisión alguna por parte del centro ni/o de los profesionales sanitarios que faciliten dicha información.
Disclaimer
version:
Ayuda
Para solicitar ayuda con iConnect/Veeva contacte a su administrador local
Sending PDF
Processing PDF...
Información básica sobre la política de privacidad y disclaimer legal
Esta herramienta no recoge datos personales de sus usuarios. Los datos no personales recogidos para la provisión del servicio tienen como únicos propósitos el reporte y targeting interno. Los datos no personales recogidos pueden incluir, pero no están limitados a, datos de volumen del equipamiento, infraestructura, o profesionales sanitarios vs los requerimientos (por ejemplo: número de salas, sillas/sillones, existencia de equipamiento para la medición de la presión arterial, número de enfermeras en el servicio), horario de apertura del centro, número de horas disponibles de las salas, las enfermeras, tiempo dedicado a la administración y observación de esketamina en espray intranasal, estimación del tiempo de enfermería.
Llegada al centro
Una vez llegue al centro, el paciente se registrará en el mostrador/recepción. Posteriormente, el paciente será dirigido a la sala correspondiente. El paciente podrá o no estar acompañado de un cuidador.
Sala de espera
El paciente esperará en la sala de espera hasta que se le invite a pasar a la consulta o bien se le llevará directamente a la sesión de tratamiento.
Consulta
Las consultas son clave, especialmente al principio. Posteriormente, pasarán a ser “ad hoc”, en función del paciente y de la necesidad de consulta. El médico puede comentar la eficacia del tratamiento, acontecimientos adversos potenciales, etc…
How to administer SPRAVATO®
Pre-administration
- Blood pressure should be measured before SPRAVATO® administration
- If a patient’s blood pressure is elevated (cf. risk minimization guide (for HCPs)), please reconfirm their blood pressure
- If a patient’s blood pressure is still elevated, consider lifestyle or pharmacological intervention to reduce blood pressure prior to starting SPRAVATO® treatment
- Consider the individual patient’s benefit and risk before deciding whether to delay SPRAVATO® treatment
Administración
SPRAVATO® is intended to be self‑administered by the patient under the direct supervision of a healthcare professional. A treatment session consists of nasal administration of SPRAVATO® and a post‑administration observation period in settings where this can be performed. Please refer to the dosing and administration guide or to the summary of product characteristics (SmPC) for full details of prescribing information.
-
Step 1 Get ready
-
Step 2 Prepare device
-
Step 3 Prepare patient
It is recommended that healthcare professionals wear protective gloves while assisting patients
At each session, instruct patient to blow nose before first device only
Confirm required number of devices
Check expiration date (’EXP’)
If expired, get a new device
Peel blister and remove device
Do not prime device – this will result in a loss of medication
Check that indicator shows 2 green dots. If not, dispose of device and get a new one
Hand device to patient
Patient should:
Hold device as shown with the thumb gently supporting the plunger
Do not press the plunger
Recline head at about 45 degrees during administration to keep medication inside the nose
-
Step 4 Patient sprays once into each nostril
-
STEP 5 Confirm delivery
and rest
Patient Should:
Insert tip straight into the first nostril
Nose rest should touch the skin between the nostrils
Patient should:
Breathe in through nose while pushing plunger all the way up until it stops
Sniff gently after spraying to keep medication inside nose
Switch hands to insert tip into the second nostril
Take device from patient
Check that indicator shows no green dots. If you see a green dot, have patient spray again into the second nostril
Check indicator again to confirm device is empty
Patient should:
Rest in a comfortable position (preferably, semi-reclined) for 5 minutes after each device
Do not blow nose
If liquid drips out, dab nose with a tissue
Ensure that the patient waits 5 minutes after each device to allow medication to absorb
Periodo de observación
Se debe vigilar al paciente para detectar cualquier acontecimiento adverso transitorio, incluida la sedación, síntomas disociativos y el aumento de la presión arterial, hasta que el paciente esté clínicamente estable según el criterio clínico.
Salida del centro sanitario
PRECAUCIÓN: Antes de la administración de esketamina en espray intranasal, se debe indicar a los pacientes que no realicen actividades potencialmente peligrosas que requieran un estado de alerta mental y coordinación motora completas, como conducir un vehículo o utilizar maquinaria, hasta el día siguiente después de un sueño reparador. SPC
Ayuda para evaluar si el paciente puede irse
Las evaluaciones clínicas incluyen:
- Estados disociativos transitorios y trastornos de la percepción: ¿Confirma que el paciente no presenta signos disociación o cambios en la percepción que puedan alterar su funcionamiento?
- Alteraciones en la consciencia (sedación):¿Confirma que el paciente está completamente despierto y que responde a estímulos (es decir, no experimenta signos de sedación)?
- Aumento de la presión arterial: ¿El paciente presenta niveles de presión arterial aceptables?
- Otros acontecimientos adversos: ¿Se ha resuelto algún otro acontecimiento adverso?
- ¿Ha advertido al paciente de que no debe conducir o utilizar maquinaria, hasta el día siguiente después de un sueño reparador?
- ¿Ha planificado el paciente viajar a su casa en transporte público o que alguien lo lleve a casa?
- ¿Usted, como profesional responsable del tratamiento, cree que el paciente está preparado para abandonar el centro sanitario?
Sala de administración y observación
In order to be able to implement SPRAVATO® within the site of care, eligible rooms need to be available for patients.
The rooms need to be suitable for (1) administration of the product and (2) for post administration observation. These 2 steps do not need to occur in different rooms.
Llegada al centro sanitario
No se espera que el tiempo empleado en este paso involucre a un Profesional Sanitario
Silla/ sillón
In order to be able to implement SPRAVATO® within the site of care, chairs need to be in place.
Reclining chairs are not required but may be more comfortable for patients, who need to lean back with an angle of 45° during the administration step.
Sala de espera
No se espera que el tiempo empleado en este paso involucre a un Profesional Sanitario
Monitor de la presión arterial
In order to be able to implement SPRAVATO® within the site of care, blood pressure a monitoring device
needs to be in place to measure the patients’ blood pressure before and after the self-administration. Several
devices might be needed depending on the number of patients.
Consulta
Evidence of therapeutic benefit should be evaluated at the end of induction phase to determine need for continued treatment. SPC
The need for continued treatment should be reexamined periodically. SPC
Assessment of contraindications and concomitant medications should take place, plus patient medical history (and assessment of history of substance abuse).
There will be a consultation before the first administration, where the physician will check suitability for treatment (e.g. contra-indications, need for lifestyle or pharmacological intervention prior to starting SPRAVATO ® treatment in case of elevated blood pressure...). The decision to prescribe SPRAVATO® should be determined by a psychiatrist.SPC
At the end of induction period there will be a consultation to check for evidence of therapeutic benefit. Consultations during the maintenance phase will check for dosing frequency and the need for continued treatment.
Tiempo requerido del profesional sanitario
Implementing SPRAVATO® within the site of care will require healthcare professional(s) to be available for the administration and post administration observation period.
Spravato is intended to be self-administered by the patient under the direct supervision of a healthcare professional.The patient then needs to observed by a healthcare professional during a post administration observation period.SPC
Safe storage
The nasal sprays needs to be stored in a dry, safe compartment preferably close to the location where the SPRAVATO® is being administered. The disposal of the device depends on the local region.
Administración
Periodo de observación
Patients should be monitored by a healthcare professional after SPRAVATO® administration at each treatment session:
- Measure the patient’s blood pressure at around 40 minutes after administering the full dose of SPRAVATO® (after administering the last nasal spray). If their blood pressure is elevated, continue to regularly measure it until it returns to acceptable levels.
- Regularly monitor the patient for signs of dissociation, sedation and any other adverse events.
- Approximately half (≥44.3%) of patients are ready to be discharged within 1 hour. - Popova V, et al. Am J Psychiatry 2019;176(6):428-438.
- Almost all (93.2%) patients are ready to be discharged within 90 minutes. - Popova V, et al. Am J Psychiatry 2019;176(6):428-438.
Salida del centro sanitario
Ayuda para evaluar si el paciente puede irse
Impact on patient
Impact on site of care
Requirements
Impact on patient
Impact on site of care
Requirements
Impact on patient
Impact on site of care
Requirements
Impact on patient
Impact on site of care
Requirements
Add option for priority drivers in site of care decision making
Edit option
Patient "carer" involved in pathway
- ++ Llegada & Salida del centro sanitario
- ++ Administración
- +++ Periodo de observación
Allow for the patient to be accompanied by a ‘carer’ (e.g. spouse, family member, friend), who could be with the patient during the post-administration observation, and support the patient throughout the journey.
Impact on patient
- Patient supported by a known person
Impact on site of care
- Observation may be done more efficiently with 'carer' support
- Reduction in observation phase HCP effort as emotional and practical support of certain side effects are taken up by ‘carer’ (e.g. anxiety, dissociation)
Requirements
- Ability / capacity for the ‘carer’ to support the patient during clinic appointments and on the way to and from the clinic (can e.g. be combined with other options)
- Willingness from the board/psychiatrist to allow ‘carer’ in administration and post-administration observation environment
Simplified administration system
- ++ Llegada al centro
Implement a simplified administration system, as often used for indications with frequent hospital visits, for decreasing the administrative burden for the patient (e.g. no registration at a desk and use of ID card), allowing for easier access to the observation room and faster treatment start.
Impact on patient
- Easier access to treatment
- Less time spent in the site of care
Impact on site of care
- Minimised impact of busy periods at administration desk on the patient arrival pattern (i.e. decrease in people turning up late for treatment)
Requirements
- Infrastructure requirements (patient badges, …)
- Payment and administrative system dapted to such a set-up (e.g. for payment)
Patient profile tracking
- +++ Periodo de observación
Make notes of individual patient experience on treatment so it can be used for subsequent treatment sessions to optimise their experience.
Impact on patient
- Allows for personalised approach of treatment for the patient
Impact on site of care
- Better knowledge and history of patient side effects during observation phase
- Higher administrative requirements for nurses
- Investment in profile template creation required
Requirements
- Deployment of a tool and/or procedures for tracking patient specificities
- When patient information is already in place, this can be leveraged for an holistic patient overview
Hospital layout
- + Total pathway
Optimised location and layout of site of care while considering the flow of patients and considering specific needs, e.g. disabled people. Improve traffic flow (e.g. observation rooms close to admission desk or secondary entrance) and eliminate redundancy (e.g. avoid 2 steps admissions).
Impact on patient
- Less time spent in the site of care
- Easier & smoother journey
Impact on site of care
- Reduction of the idle time of the HCP for moving in the site of care
- Higher administrative requirements for nurses
- Optimised utilisation of HCP and rooms
Requirements
- Can require significant investments
- Can require activities at a broader scale than the practice at stake
- Requires dedicated analysis on the patient flow and physical journey
Optimised staffing approach
- +++ Physician-Time
- +++ Nurse-Time
- +++ Space
Changing the staffing mix to decrease overall cost of effort for taking care of patients (e.g. leverage junior nurses for post-administration observation of known patients, optimised frequency of physician consultations).
Impact on site of care
- Optimisation of staff utilisation & potential for additional capacity creation
Requirements
- Sufficient time-size and critical mass to allow for organisational optimisation
Efficient observation time planning
- +++ Nurse-Time
In a prolonged observation phase, the available free time can efficiently be used by the nurse to do additional work. E.g. administrative work. The nurse can also sit in the same room as the patient(s) - have a desk and just do some paperwork etc.
Impact on patient
- No continuous observation
- Observation based on frequent check-ups
Impact on site of care
- Optimised utilisation of HCP time
Requirements
- Nurse needs to be able to do frequent check-ups on patient
Joint patient observation
- ++ Nurse-Time
- +++ Space
For the maintenance phase of the treatment, set-up a dedicated room with the necessary equipment for administration and post-administration observation of several patients in parallel, in order to reduce the number of required HCP and room(s).
Impact on patient
- Lack of privacy during observation phase
- Potential incompatibility of patients during treatment (i.e. based on reaction to treatment)
- Patient more closely observed during the post-administration observation
Impact on site of care
- Optimised utilisation of HCP time
- Optimised utilisation of available space
- No exclusive observation
Requirements
- Availability of sufficiently large rooms at the site of care
Low-utilisation infrastructure
- ++ Space
The use of under-utilised infrastructure (e.g. specific times) of neighbouring departments (e.g. oncology).
Impact on patient
- Can lead to logistic challenges for patient
Impact on site of care
- Increases in capacity for patient care
- Optimised utilisation of HCP time
- Optimised utilisation of available space
Requirements
- Availability of low-utilisation infrastructure close to the practice
Disponibilidad del centro
Lunes
Martes
Miércoles
Jueves
Viernes
Sábado
Domingo
Disponibilidad
Sillas
Hora de comienzo
Hora de finalización
Room 1
Disponibilidad
Sillas
Hora de comienzo
Hora de finalización
Room 1
Room 2
Room 3
Disponibilidad
Sillas
Hora de comienzo
Hora de finalización
Room 1
Room 2
Room 3
Disponibilidad
Sillas
Hora de comienzo
Hora de finalización
Room 1
Room 2
Room 3
Disponibilidad
Sillas
Hora de comienzo
Hora de finalización
Room 1
Room 2
Room 3
Disponibilidad
Sillas
Hora de comienzo
Hora de finalización
Room 1
Room 2
Room 3
Disponibilidad
Sillas
Hora de comienzo
Hora de finalización
Room 1
Room 2
Room 3
Site of care availability
lunes
martes
miércoles
jueves
viernes
sábado
domingo
Sala(s)
Silla(s)/Sillón(es)
Sala 1
Sala 2
Enfermero(s)
Enfermero 1
Enfermero 2
Enfermero 3
Médico(s)
Médico 1
Médico 2
Médico 3
Sessions
Session 1
Session 2
Session 2
Procesamiento de pdf...