Letting kids be kids again with CADD Solis VIP for blinatumomab infusions.

373 Background: Blinatumomab is a bispecific T-cell engager that binds CD19 on B cells and CD3 on T cells. It is FDA approved for frontline treatment for patients with CD19-positive, Philadelphia chromosome-negative B-cell precursor acute lymphoblastic leukemia (ALL) for adults and pediatric patients aged 1 month and older. It is administered via continuous intravenous infusion over a 28-day period. Historically, two separate infusion pumps were used for blinatumomab administration: Alaris pumps the institution inpatient electric infusion pump and Sapphire Multi-Therapy pumps in the outpatient setting. This dual-pump system complicated care transitions, limited discharge timing to weekdays, and was associated with frequent pump-related technical issues. Methods: To improve blinatumomab administration in pediatric patients and to enhance the safety and efficiency of patient transitions between inpatient and outpatient care, a quality improvement initiative was implemented to standardize the use of a single infusion pump across all care settings. Multidisciplinary stakeholders collaborated to pilot CADD Solis VIP initially in the outpatient setting. Training protocols were developed, Beacon order builds and workflows updated and implemented to successfully implement a phased rollout of the single-pump process. Data were collected on discharge timing, pump alarms, interruptions, and unplanned visits. Results: In the two years prior to the pilot, 17 patients received blinatumomab using the historical two-pump process. Approximately 50% of these patients experienced at least one infusion-related issue. Reported complications included frequent alarms for air in the line, pumps running dry over weekends, and persistent beeping, resulting in unplanned infusion visits or hospital readmissions. Additional issues included delays in medication readiness, incorrect tubing setup, and interruptions. Following implementation of a single-pump model, 18 patients received at least one cycle of blinatumomab via the new process. Only two low-volume alarms were reported, both occurred immediately prior to a scheduled infusion appointments and did not disrupt care. One patient returned due to air in the line; investigation revealed a large air bubble in the cassette. This event led to a revision of the final product verification process to ensure complete removal of air during pharmacy preparation. Conclusions: Standardizing to a single infusion pump for blinatumomab delivery across care settings significantly improved workflow efficiency, reduced technical complications, and facilitated timely patient discharges, including on weekends. This approach enhanced both patient and caregiver satisfaction, supported smoother care transitions, and reduce the burden on team members. It may serve as a model for optimizing continuous infusion therapies in pediatric oncology across inpatient and outpatient settings.