Bridging the Gap – Educating and Preparing a Medical Oncology Unit to Care for the Stem Cell Transplant Patient

Background: With a rapid increase in stem cell transplant patient admissions, a Medical Oncology unit urgently became the transplant overflow unit.  Medical Oncology staff was unprepared and individual staff previously only encountered the transplant patient during floating to the transplant unit. The transplant patients had high acuity and complex needs with multiple complications in enormous proportions. The Medical Oncology staff had some educational situational barriers to impeding the ability to quickly adapt to the new patient influx.  

Objective:On an 18-bed Medical Oncology unit at a small NCI –designated medical center, the knowledge base for caring for the transplant patient varied greatly. Collaborating with the unit educator, the Assistant Nurse Manager created a needs assessment for the staff to evaluate their own level of exposure and competence and to identify gaps in knowledge.

Methodology:Utilizing Survey Monkey to anonymously gather the data, a needs assessment was opened to staff for completion over a one month period. The assessment was divided into two main areas: Preparative regimens including chemotherapeutic agents, Irradiation and monoclonal antibodies and complications related to transplant. A three option answer key was available: (1) no exposure, (2) some exposure, (3) competent. Out of the 22 staff nurses, knowledge gaps were identified and a plan was constructed. The plan includes staff meetings which would contain an educational component on the transplant patient;  lectures from pharmacy, the unit’s educator and assistant manager; Staff participation in “eat and learn” 5 minute didactic  sessions; identification of DRGs and co-morbidities specific to the unit; and educational material to be made available on HopeBoard, the institution’s version of Blackboard.

Discussion: Augmenting the knowledge and training of the staff decreases anxiety in caring for a new patient population while promoting enhanced patient care with early detection. Implementation of this plan is set to occur in October. There are many competing priorities but improved patient care and outcomes remains the main goal.