115 - Building a Hyperthermic Intraperitoneal Chemotherapy Program at Safety-Net Hospital

Description: Description of team: The development and launch of the HIPEC (Hyperthermic Intraperitoneal Chemotherapy) program was a collaborative effort involving a highly coordinated, multidisciplinary team. Key members included the Surgical Oncology Coordinator, operating room charge nurses, circulating nurses, scrub surgical technologists, board-certified surgical oncologists, anesthesia providers, sterile processing leaders, and perioperative nursing leadership. This diverse team worked across departments to build protocols, standardize equipment, and ensure clinical readiness for a high-acuity surgical program.

Preparation and planning: Cytoreductive surgery with HIPEC is among the most complex procedures in surgical oncology, requiring meticulous planning to protect both patients and staff.


Assessment: A comprehensive gap analysis was conducted to assess the hospital's baseline readiness for introducing the HIPEC program. This included evaluating current OR capabilities, staff familiarity with cytoreductive oncology procedures, and infrastructure for chemotherapy delivery. Feedback from all members of the surgical team during initial first cases was used to fine-tune logistics and safety protocols.

Implementation: The Surgical Oncology Coordinator led the implementation process by establishing five core categories essential for success:
Staffing: Identification and training of a dedicated core team for consistency and skill development.
Education & Simulation: Implementation of interactive online modules, and access to resources relating to HIPEC and oncology patients in the perioperative suite.
Protocols & Policies: Development of detailed workflows, emergency plans, and safe handling protocols for chemotherapeutic agents.
Supplies & Equipment: Sourcing and standardization of HIPEC-specific instrumentation and perfusion equipment.
Environmental Safety: Ensuring proper PPE usage, waste disposal processes, and OR ventilation requirements were in place.

Outcome: Following program implementation, the hospital experienced a measurable increase in the number of advanced surgical oncology procedures performed during the fiscal year. More importantly, the program significantly expanded access to life-extending HIPEC treatment for Medicare/Medicaid-dependent patients who would otherwise lack access at other medical centers. Staff confidence, procedural efficiency, and interdisciplinary teamwork all improved based on post-case debriefing surveys and quality metrics.

Implications for perioperative nursing

The perioperative nurse plays a pivotal role in the success of a HIPEC program, from anticipating patient needs and managing chemotherapeutic safety measures to coordinating across multiple teams. This initiative demonstrated that with adequate training, teamwork, and standardized protocols, perioperative nurses at a safety-net hospital can support and sustain a high-acuity oncology program. Their adaptability, clinical judgment, and commitment to patient safety are essential in providing equitable access to cutting-edge surgical care.