Moving Practice Forward; Standardization of Infusion Times for Hematopoietic Cells Utilizing an IV Pump

Significance: BMT recipients have a 12F central venous catheter (CVC) placed prior to transplant to accommodate hydration, medications, and blood testing.  This catheter is also required to ensure rapid infusion of hematopoietic cell products via gravity. Variation of cell product infusion times exists during gravity infusions related to patient symptoms, patency of the CVC, rate at which the nurse infuses the product, types of cells infused.  Standardizing the cell product infusion time utilizing an IV pump eliminates variation and provides both the nurse and patient with a better experience.

Purpose: The main purpose was to determine if hematopoietic cells infused via IV infusion pump over a set period of time provided patients with less symptoms than gravity infusions and nurses with a more efficient way of delivering cells.

Interventions: Practices of hematopoietic cell infusions at other transplant centers were assessed.  Cell viability of cryopreserved cell products after utilizing an IV pump for infusion was determined.  Samples of frozen products were infused via IV infusion pump to determine cell viability post infusion.  A new procedure was written to infuse hematopoietic cell products via an IV infusion pump with standardized infusion times. A symptom assessment survey was completed by patients for comparing gravity infusions with infusions via the IV pump.  Nurses were survey regarding this change in practice.

 Evaluation: Patient symptoms were rated for cryopreserved cell infusion prior to and after the initiation of a standardized infusion time of 10 minutes.  Nurses were asked to rate the efficiency of utilizing an IV pump compared to gravity infusion. Patients who entered the program with a previous placed catheter that was not a 12F CVC were tracked to determine a potential cost benefit.

Discussion: By utilizing standardized infusion times and an IV pump both nurses and patients have a better experience with cell infusions.