Ambulatory care

The decision on who can be ambulatory is one which is carefully considered to ensure your safety throughout the process. There are number of eligibility criteria that your consultant must agree that you have met. 

If you have been identified as potentially being eligible for Ambulatory Care then you will receive information regarding this in your stem cell transplant pack. You will need to complete a consent form. 

One of the Team will also meet with you and your carer at your QEUH BMT clinic appointments and will follow your journey throughout the ambulatory stage of your transplant. 

The length of time that you need to stay each day will vary depending on the treatment that you are due that day. You will receive a treatment schedule that will give you a rough guide on how long you should expect to be on the ward each day but it is important to note that this is a guide and this time may vary.  

On the first day you attend ward 4B you’ll be welcomed to our ward and shown to your room. We will do a covid test on arrival and we ask that you continue to wear your mask until this result is back.  Providing the result is negative you can then remove your mask when inside your room in ward 4B. We would request that you wear a mask when arriving and leaving the hospital. 

This day will be used to get you organised for starting treatment. If you don’t have Hickman line already you will attend a pre-arranged appointment for insertion. Your nurse will go through your admission documentation with you and explain your protocol which details your treatment day-by-day. Bloods will be obtained on a daily basis and your Hickman line will be cleansed and redressed. You may also attend for a CXR. Your nurse will also explain your mouth and skin care advice.  

You will meet one of our ANPs and pharmacists who will clerk you in and make sure all your medications are prescribed. A routine ECG will be taken to obtain a baseline tracing of your heart for our records. Once all of this completed you can go home.  

We will give you a blood pressure cuff and saturation probe to take home on loan and training on their use will be given. We ask that you take your temperature at least twice a day at home and report any fevers promptly. You don’t need to use the blood pressure cuff or saturations probe unless asked to by a member of staff. 

In the days that follow you will be given a time to attend the ward. This will allow you to plan your day but it also allow us to plan our workload so we would kindly as that you adhere to these times.  

On arrival you will have a set of observations carried out and your daily bloods will be obtained by your nurse. We will assess you for any symptoms that may be developing or becoming problematic. Your treatment will them be given as per your protocol. If further treatment is require such as blood transfusions or fluids this will be given in Ambulatory care. We will endeavour to give you forewarning regarding these needs where possible to allow you to plan your day. In addition to your nursing review you will also be reviewed by a Registrar or an Advanced Nurse Practitioner (ANP).  

If you are running out of any medications or have difficulty taking them, it is important that you let your team know so that we can address this.  

While you are attending as an ambulatory patient, the care pathways—including input from Allied Health Professionals and Consultant Clinical Psychologists—remain consistent with those provided during inpatient admission. 

It is important that you contact our team at any time of day or night if you or your carer are concerned, particularly if you develop any of the following symptoms: 

• Shivers or hot flushes, dizziness
• Temperature of 38⁰C or above
• Persistent episodes of vomiting and/or diarrhoea
• Shortness of breath or difficulty with your breathing
• Redness or pain around your central line
• Bruising or bleeding of any sort
• Chest pain
• Problems passing urine

If you develop any of the above please contact the ward staff on 0141 452 2430 immediately and a member of the team will triage your call, informing you of the next steps to take. Depending on your symptoms, it may be necessary to admit you to hospital to be monitored more closely and receive additional treatments such as fluids or antibiotics that cannot be managed in the ambulatory setting. 

If you experience any infective symptoms e.g. sore throat, flu-like symptoms or diarrhoea please phone and inform us in advance as we may be required to isolate you from other patients. This also applies if a family member or friend has symptoms and needs to accompany you to the hospital. 

The team at the ward will be available 24/7 for support and advice and would welcome you to contact them should you have any queries or concerns.

• We would recommend that you bring an overnight bag with you in case it deemed necessary for you to be admitted.  
• Books/magazines 
• Your medications
• Mobility aids that you require

When discharged from Ambulatory Care you will be given: 

• A discharge letter which contains information about your current treatment and future treatment plan.
• Information on what to do and whom to call if you have any problems once discharged from Ambulatory Care.
• Your next clinic appointment
• An appointment for line care by your day unit/local hospital/district nurses if applicable.
• Date for the next blood tests

“Spending more time at home with family and home comforts such as your own bed. Easing into the Hospital environment, getting to know the staff, the ward, and the process before having to stay for a prolonged period. Breaks down the treatment into more manageable steps. Getting to meet staff and see how competent and committed they are on helping you to get better. Finally, Lisa Halliday was fantastic in her depth of knowledge and enthusiasm. She kept in regular contact and helped put my mind at ease and seemed genuinely invested in my care.”  

“Having advance access to the staff and room environment prior to admission. This provides large feeling of confidence in the treatment to come and level of care the staff would be providing. It also lessened the anxiety associated with getting a new form of treatment when being admitted. Quality of care and monitoring provided, meant that when I had to pivot to stay in, I did not need to go through admission at local A&E at Monklands for stabilisation and later transfer. This was a massive benefit of the care received while in Ambulatory Care, although the back up of local A&E and the call line card would have been available if I needed it out of hours.” 

“Most importantly my wife was allowed to feel normal with Ambulatory Care, by going in and out on her own terms, initially having control of her treatment in some way or other, with times that was agreed with all parties and knowing that she had her own place, everyone knew who she was and that she was always coming and going and had a very friendly feeling about the whole thing.” 

“Advantages- being at home, with family, in afternoons and evenings particularly for first few days when feeling very well. Being able to be outside including dog walks and eating home food.” 

“Huge, giant benefits from the Ambulatory service for the run-in to the transplant. Fabulous, expert care from the team.” 

“It was very helpful to meet Lisa face to face at clinic and then to be followed up with a near me appointment with her. Written information was clear and helpful in knowing what to expect on admission.” 

“I would highly recommend this service and Lisa was incredibly supportive throughout my admission. Psychological - Familiarity of home at the end of the day is a big help. Avoid hospital food as I can get better nutrition at home. You don’t feel that you are ‘a sick person ‘. Feeling healthy in your head helps re I wry and well-being” 

“I appreciated the care I received at the QEUH, every member of staff I spoke to has been helpful, friendly and professional. Being able to spend the evenings relaxing at home made it easier as I wasn’t in need of round the clock care or attention.”