Implementation and evaluation of a nurse-allied health clinic for patients after haematopoietic stem cell transplantation

Nakagaki, Midori; Gavin, Nicole; Hayes, T. G.; Fichera, R.; Stewart, Caroline; Naumann, Leonie; Brennan, Justine; Perry, Natasha; Foley, Emma; Crofton, Erin; Brown, Christie; Leutenegger, Jenni; Kennedy, Glen

doi:10.1007/s00520-021-06461-w

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…However, patients treated with UCBT have higher rates of readmission than with other kinds of hematopoietic stem cell transplantation (HSCT) [ 3 ]. In addition, HSCT recipients face severe challenges after discharge, such as continued immunosuppression and management of transplant-related complications, which seriously affects their quality of life (QoL) [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Implementation and Evaluation of Discharge Planning for Patients Undergoing Umbilical Cord Blood Transplantation

Huang,

Zhu,

et al. 2024

Ann Transplant

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Background:Umbilical cord blood transplantation (UCBT) patients have high rates of unplanned readmissions and poor quality of life (QoL). The aim of this study was to evaluate the effects of discharge planning on unplanned readmissions, self-efficacy, QoL, and clinical outcomes. Material/Methods:Patients who received their first UCBT from April 2022 to March 2023 were included. Participants (n=72) were assigned to a control group (CG: received usual care) or an intervention group (IG: received discharge planning from admission to 100 days after UCBT). The cumulative readmission rates 30 days after discharge and 100 days after UCBT were analyzed using the log-rank test. Self-efficacy and QoL were assessed at admission and 100 days after UCBT using the General Self-Efficacy Scale and FACT-BMT version 4, clinical outcomes derived from medical records. Results:Sixty-six patients completed the study. Discharge planning did not reduce readmission rates 30 days after discharge (20.59% vs 31.25%, P=0.376) or 100 days after UCBT (29.41% vs 34.38%, P=0.629). However, the IG showed significantly better self-efficacy (P<0.001), and except for social and emotional well-being, all the other dimensions and 3 total scores of FACT-BMT in the IG were higher than for the controls at 100 days after UCBT (P<0.05). Conclusions:The discharge planning program can improve self-efficacy and QoL of UCBT recipients. The implementation of discharge planning for patients undergoing UCBT was necessary for successful hospital-to-home transitions.

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Section: Introductionmentioning

confidence: 99%

Implementation and Evaluation of Discharge Planning for Patients Undergoing Umbilical Cord Blood Transplantation

Huang,

Zhu,

et al. 2024

Ann Transplant

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“…Discharge occurs prior to achieving full immunocompetence which places the child at high risk for lifethreatening complications or infections and subsequent readmission (Shulman et al, 2015). This time proves enormously challenging as the caregiver and the patient work to balance the urge to live a "normal" life with the restrictions of immunodeficiency, nutritional insufficiencies or GI upset, lack of energy, utilization of durable medical equipment (DME), and timing of medications (Cooke et al, 2012;Nakagaki et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, caregivers of P-HSCT patients report that the gravity associated with the P-HSCT experience leads to high levels of financial strain, anxiety, posttraumatic and psychological stress all of which combined develop into a significant decline in quality of life for the entire family (Mangurian et al, 2018;Nakagaki et al, 2021;Tillery et al, 2018). Caregiver coping decreases and their ability to understand extensive discharge information during the transition of care from hospital to home declines (Lerret et al, 2016;Richardson et al, 2018;Runaas et al, 2017;Wu et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Standardization of Pediatric Hematopoietic Stem Cell Transplant Patient Discharge to Reduce Readmission Rates

West,

Varnes,

Hudspeth

2023

Journal of Pediatric Hematology/Oncology Nursing

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Background: The time period after a pediatric hematopoietic stem cell transplant (P-HSCT) is tenuous as the patient is severely immunocompromised and awaiting immune reconstitution. Managing activities of daily living and medication administration after discharge from the hospital requires 24-hour care placing a heavy burden on caregivers and patients. Patients who do not adhere to the posttransplant regimen are at a higher risk for hospital readmission within the first 30 days of initial discharge with serious potential for life-threatening complications. The objective of this project was to improve 30-day readmission rates and caregiver readiness for discharge through the implementation of an evidence-based discharge protocol for P-HSCT patients and caregivers. Methods: This quality improvement project included development and implementation of comprehensive Pediatric Blood & Marrow Transplant Guidelines and discharge protocol for patients who received an inpatient autologous or allogeneic HSCT and were scheduled for discharge from a 16-bed inpatient pediatric hematology–oncology unit of a children's hospital in the southeastern United States. Readmission rates were captured through the hospital-monitored system. Results: The comprehensive discharge protocol was implemented for six patients, and 30-day readmission rates decreased from 27.29% to 3.57% following the intervention. Discussion: Results suggest the combination of an evidence-based discharge protocol with a focus on caregiver readiness for discharge and a 24-hour Rooming-In period can influence caregiver confidence and reduce 30-day readmission rates after initial discharge from a P-HSCT.

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Critical Care Nursing of Haematopoietic Stem Cell Transplantation Patients

Botti

Seligardi

2023

Pulmonary and Critical Care Considerations of Hematopoietic Stem Cell Transplantation

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Implementation and evaluation of a nurse-allied health clinic for patients after haematopoietic stem cell transplantation

Cited by 4 publications

References 20 publications

Implementation and Evaluation of Discharge Planning for Patients Undergoing Umbilical Cord Blood Transplantation

Implementation and Evaluation of Discharge Planning for Patients Undergoing Umbilical Cord Blood Transplantation

Standardization of Pediatric Hematopoietic Stem Cell Transplant Patient Discharge to Reduce Readmission Rates

Critical Care Nursing of Haematopoietic Stem Cell Transplantation Patients

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