Due to the curative potential and improvement in progression-free survival (PFS), high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is considered the standard of care for several hematologic malignancies, such as multiple myeloma, and lymphomas. ASCT typically involves support with blood product transfusion. Thus, difficulties arise when Jehovah's Witness patients refuse blood transfusions. In order to demonstrate the safety of performing "bloodless" ASCT (BL-ASCT), we performed a retrospective analysis of 66 Jehovah's Witnesses patients who underwent BL-ASCT and 1114 non-Jehovah's Witness patients who underwent transfusion-supported ASCT (TF-ASCT) at Cedars-Sinai Medical Center between January 2000 and September 2018. Survival was compared between the two groups. Transplant-related complications, mortality, engraftment time, length of hospital stay, and number of ICU transfers were characterized for the BL-ASCT group. One year survival was found to be 87.9% for both groups (P = 0.92). In the BL-ASCT group, there was one death prior to the 30 days post transplant due to CNS hemorrhage, and one death prior to 100 days due to sepsis. Based on our data, BL-ASCT can be safely performed with appropriate supportive measures, and we encourage community oncologists to promptly refer JW patients for transplant evaluation when ASCT is indicated.

No abstract

collections of stem cells and autologous therapeutic cells rose by 23% to an all time high of 106 collections in one month. The average number of individual patients per week rose from 8.7 (standard deviation 2.4) to 11.2 (standard deviation 1.8). Nursing safety standards were not exceeded, and management involvement in resolving scheduling conflicts dropped from two requests per week to one in two months. Conclusion: By changing apheresis scheduling method to day one scheduling only, we were able to increase throughput without having to make any additional adjustments to resources. The clearer format resulted in increased staff satisfaction with the scheduling process. This change represented a paradigm shift from previous scheduling models, and has yielded a major improvement in use of resources. Additionally, it provides a dynamic tool to support evaluation of facility utilization to meet future demand.

staff, leadership. 4. Rejuvenation of shared governance at the unit level. Results: To determine the influence of the ANM role, a staff engagement survey was re-administered and compared to the 2010 results. The results showed a dramatic increase in staff engagement and satisfaction, as evidenced in the attached table. In addition, since the ANM role was established, nurse certification has increased by 120% and nurses pursuing higher education has increased 700%, supporting the premise that the ANM role had a positive influence in professional nursing development. Discussion: The ANM role had a positive influence on staff engagement, satisfaction, and professional growth. Effective motivational strategies combined with a functional management structure cultivates an environment where the highest level of quality care can be delivered.

Background: To ensure the highest degree of accuracy for the CIBMTR (Center for International Blood and Marrow Transplant Research) data, the Penn State Milton S. Hershey Medical Center Bone Marrow Transplant Program has created Powerforms integrated into the EMR (Electronic Medical Record) for GVHD (Graft versus Host Disease) and PS (Performance Status) Assessment. In 2008, the data manager was able to change the GVHD and PS Assessment from a paper based method to an Electronic method. Methods: The Bone Marrow Transplant Data Manager collects GVHD Assessment for all Allogeneic Transplant patients, and Assessments for patients on the research track at the time periods of Day 100, six months, and yearly post-transplant. The assessments are collected in the EMR. The Attending Physicians then review, modify if needed, and sign the assessment forms. These forms are used as source documentation during CIBMTR Data Submission Audits. Results: Our results show a decrease in errors found during a CIBMT audit. The NMDP Audit in 2004 showed an overall error rate (OER) of 1.2% and a Critical Error Rate (CER) of 2.8%. PS errors were 47.9% of the CER, and GVHD errors were 14.6% of the CER. In 2008, the audit showed a 1.7% OER and a 3.8% CER. PS errors were 24.5% of the CER, and GVHD were 3.8% of the CER. In 2012, the audit showed a 0.7% OER and a 0.8% CER. PS errors were 4.3% of CER and GVHD were 4.3% of CER. Conclusion: Implementing the collection of GVHD and PS assessment using the EMR has decreased the error rate found on the CIBMTR Audit. The continuation of this method of data collection can further reduce the error rate.