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The purpose of this project was to establish a program of competency for bone marrow transplant nurses regarding administration of Stem Cells on Day 0 of transplant hospitalization and to provide education to the patients and families about what to expect during transplant.
In this institution the responsibility of infusion of stem cells historically belonged to the midlevel providers and physicians. The literature does not specify who should administer the stem cells but the FACT (Foundation for the Accreditation of Cellular Therapy) standards state that “There shall be a policy addressing safe administration of cellular therapy products.” This project highlights education of nurses, nursing management during stem cell infusion and patient/caregiver education for monitoring of adverse reactions during and after infusion of stem cells. We realized the importance of training nurses correctly, making them feel comfortable with the procedure and provide patients with the safest stem cell administration possible.
Methods, Intervention, & Analysis
Development of a systematic education program was important to make sure nurses learned the knowledge behind the procedure of stem cell infusion. This included reading and understanding processes from BMT Standard Operating Procedures, preparing premeds, emergency equipment and IV supplies, verifying stem cell products with blood bank staff, performing stem cell infusion, monitoring vital signs and watching for signs of a reaction, and documenting the stem cell infusion.
Findings & Interpretation
We accomplished the development of a Stem Cell Infusion competency and training program, and 27 nurses have been fully trained to administer stem cells to BMT patients. Nine nurses are currently in training to administer stem cells. We developed resource materials to support new nurses in the learning the process, developed RN checklists for stem cell infusion procedure and developed patient education sheets in the UM Clearinghouse that simply explain the procedure of stem cell infusion for patients and families to learn.
Discussion & Implications
Patients feel comfortable when their nurse is involved in the Day 0 stem cell infusion. Patient feedback shows that nurses with confirmed competency, knowledge and skill, and the relationship with their patients and families have proven to be the ideal people to administer stem cells to their patients.