Bone Marrow Transplantation

by Buchsel, Patricia Corcoran; Whedon, Marie Bakitas; Bakitas, Marie

• ISBN13: 9780867206913
• ISBN10: 0867206918
• Format: Hardcover
• Copyright: 1995-03-01
• Publisher: Jones & Bartlett Learning

Summary

The most up-to-date, comprehensive reference available in the bone marrow field. Utilizing the experience of more than twenty oncology nurses, it addresses current challenges: to influence both ethical and administrative problem solving, to help lower costs, to improve patients' understanding of problems and risks, and to participate in decision making for research studies. This text prepares nurses for an even larger role in the continuing application of marrow transplantation.

Table of Contents

Foreword	xv
Preface	xvii
Contributors	xix
PART I Administrative Strategies	1	(168)
Bone Marrow Transplantation Nursing: Into the Twenty-first Century	3	(16)
Marie Bakitas Whedon
Introduction	3	(1)
Historical Perspectives	3	(5)
Overview of Transplant Science	8	(4)
The Future of BMT	12	(3)
References	15	(4)
Administrative Issues of an Ambulatory Care Setting	19	(20)
Patricia Corcoran Buchsel
Introduction	19	(1)
Historical Perspective	19	(1)
Planning an Ambulatory BMT Unit	20	(4)
Ambulatory Care Services	24	(7)
Nursing Administration	31	(4)
Costs of Ambulatory Care	35	(1)
Peripheral Stem Cell Transplantation	35	(1)
Research	36	(1)
Future Trends	37	(1)
Conclusion	37	(1)
References	37	(2)
Administrative Issues of an Inpatient BMT Unit	39	(30)
Linda R. Campbell
Mary Catherine Foody
Introduction	39	(1)
Strategic Planning	39	(2)
Financial Considerations	41	(2)
Resource Utilization	43	(6)
Environmental Issues	49	(2)
The Inpatient BMT Nursing Staff	51	(5)
Model for BMT Care: Nursing Care Delivery	56	(11)
Conclusion	67	(1)
References	68	(1)
Intensive Care Management of the BMT Patient: Administrative and Clinical Issues	69	(26)
Terry Wikle Shapiro
Introduction	69	(1)
Issues in Planning Care	69	(2)
Caring for the Critically Ill Patient on the Unit	71	(1)
Caring for the Critically Ill BMT Patient in the ICU	72	(1)
The Critically Ill Patient	73	(7)
Design Considerations	80	(2)
Issues in Transferring Critically Ill BMT Patients to the ICU	82	(1)
Clinical Issues	82	(10)
Conclusion	92	(1)
References	93	(2)
Administrative Issues of the Pediatric BMT Unit	95	(18)
Linda Abramovitz
Vicki Link
Introduction	95	(1)
Planning the Pediatric Unit	95	(8)
Education	103	(3)
Nursing	106	(5)
Conclusion	111	(1)
References	111	(2)
Food and Nutrition Services for the BMT Patient	113	(24)
Jean Marie Stern
Polly Lenssen
Introduction	113	(1)
The Impact of Eating Problems on Foodservice Design	113	(2)
Foodservice Administration and Staffing	115	(1)
The Low-Microbial Diet	115	(2)
Monitoring Nutrient Intake	117	(2)
Foodservice Safety and Equipment Standards	119	(1)
Issues and Concerns in Establishing a BMT Foodservice	119	(3)
Acute Care Nutrition Services	122	(6)
Ambulatory Care Nutrition Services	128	(4)
The Discharge Process and Long-term Follow-up	132	(1)
Operations and Monitoring Systems	133	(2)
Conclusion	135	(1)
References	135	(2)
Pharmaceutical Services for a BMT Program	137	(16)
Valorie J. Wilkins
Introduction	137	(1)
Planning	137	(5)
Contingency Planning and Expectations	142	(3)
Evaluation and Control	145	(5)
Conclusion	150	(1)
References	151	(2)
Discharge Planning for the BMT Unit	153	(16)
Deborah Chielens
Introduction	153	(1)
Historical Perspective	153	(1)
Discharge Criteria	154	(1)
Patient Education	154	(6)
The Caregiver Role	160	(1)
The Difficult Patient	161	(1)
Communication	162	(1)
Future Trends	162	(1)
Conclusion	162	(6)
References	168	(1)
PART II Clinical Considerations	169	(182)
Pretransplant Care	171	(16)
Carrie Malmberg
Michael W. Wilson
Introduction	171	(2)
Referral to the Center	173	(1)
Preparation for Transplantation	173	(5)
Pretransplant Evaluation and Preparation of the Allogeneic Patient and Bone Marrow Donor	178	(3)
Pretransplant Evaluation and Preparation of the Autologous Patient	181	(1)
Pretransplant Evaluation and Preparation of the Platelet Donor	182	(1)
Hospital Admission	183	(1)
Consolidation of Services and Nursing's Role	184	(1)
Conclusion	184	(1)
References	185	(2)
Peripheral Stem Cell Transplantation: Past, Present, and Future	187	(26)
Cynthia R. King
Introduction	187	(1)
Overview	188	(4)
History of PSCT	192	(1)
Transplant Process	193	(11)
Pediatric PSCT	204	(1)
Costs	205	(1)
Outcomes	206	(1)
Future Directions	206	(2)
Conclusion	208	(1)
References	208	(5)
Pain Management	213	(44)
F. Peter Buckley
Karen L. Syrjala
Introduction	213	(1)
What Do We Mean by Pain?	213	(1)
Anatomy, Physiology, and Pharmacology of Nociception	213	(3)
Patient Pain and Suffering	216	(3)
Evaluation of Pain	219	(1)
Pain Diagnostics and Therapy Selection	220	(1)
Treating the Patient	221	(1)
Nonpharmacologic Techniques	221	(5)
Nonopioid Analgesics	226	(3)
Tricyclic Antidepressants	229	(2)
Opioids	231	(15)
Invasive Analgesic Techniques	246	(1)
Clinical Pain Management for the BMT Patient	246	(4)
Analgesia/Sedation for Painful and Unpleasant Procedures	250	(2)
Medication Weaning	252	(1)
Conclusion	253	(1)
References	254	(2)
Bibliography	256	(1)
Oral Medicine Concerns of the BMT Patient	257	(26)
Michele E. Lloid
Introduction	257	(1)
Overview	257	(1)
Clinical Assesment	258	(1)
Routine Oral Care	258	(1)
The Four Stages of BMT	259	(16)
Conclusion	275	(1)
References	276	(7)
Meeting the Psychological Needs of Recipients and Families	283	(20)
Karen Syrjala
Introduction	283	(1)
Meeting Psychosocial Needs	284	(7)
Administration of Services	291	(6)
Breaking Down Barriers with Nurses	297	(2)
Conclusion	299	(1)
References	299	(4)
Home Care of the BMT Recipient	303	(20)
Lisa Schulmeister
Introduction	303	(1)
Developments in Home Care	303	(1)
Implementing Home Care Programs	304	(8)
Administrative Issues	312	(3)
Clinical Issues	315	(4)
Conclusion	319	(1)
References	320	(3)
Long-Term Complications of BMT	323	(28)
Susan Randolph
Ellen Leum
Patricia Buchsel
Introduction	323	(1)
Chronic Graft-versus-Host Disease	323	(10)
Neurological Complications	333	(1)
Late Infectious Complications	333	(2)
Ophthalmologic Complications	335	(1)
Urologic Complications	335	(1)
Oral/Dental Complications	336	(1)
Pulmonary Complications	337	(2)
Graft Failure and Marrow Dysfunction	339	(2)
Endocrine Dysfunction	341	(2)
Aseptic Necrosis of the Bone	343	(1)
Secondary Malignancies	343	(1)
Beyond BMT	344	(2)
Conclusion	346	(1)
References	347	(4)
PART III Related Issues	351	(112)
Strategies for Education of the BMT Patient	353	(12)
Patricia F. Jassak
Nancy L. Porter
Introduction	353	(1)
The Process	354	(1)
Factors Affecting Education	354	(1)
Transplant Process Education	355	(3)
Approaches to Patient Education	358	(4)
Conclusion	362	(1)
References	362	(3)
Nursing Research	365	(38)
Mel R. Haberman
Introduction	365	(1)
Developing a Testable Research Question	365	(2)
Levels of Research Inquiry	367	(1)
Characteristics of a Research Problem	368	(1)
Background for the Study and Literature Review	368	(1)
Developing a Conceptual Framework	369	(1)
Research Design: Qualitative and Quantitative	370	(12)
Factors That Jeopardize Validity	382	(3)
Optimizing Experimental Research Designs	385	(2)
Statistical Analysis Plan	387	(2)
Optimizing Study Design Integrity	389	(2)
State-of-the-Science of BMT Nursing	391	(5)
Conclusion	396	(1)
References	397	(6)
The Role of Computers	403	(24)
Valerie Coxon
Introduction	403	(1)
Computers Today	403	(2)
Health-Care Software	405	(1)
Nursing Software	406	(5)
Patient-Operated Computers: A Growing Concept	411	(5)
Uses of the Computer by the BMT Patient	416	(4)
Practical Issues in the Use of Bedside Computers	420	(3)
The Future	423	(1)
Conclusion	424	(1)
References	424	(3)
Cost Issues for BMT	427	(16)
Carol M. Moinpour
Michael K. Chapko
Keith M. Sullivan
Sally Kirk
Introduction	427	(1)
Cost-Effectiveness Analysis	428	(6)
Collecting Marrow Transplant Charges: Issues and Problems	434	(4)
Conclusion	438	(2)
References	440	(3)
Centers of Excellence for Marrow Transplantation	443	(20)
Janet P. Nelson
Introduction	443	(1)
Cost-Containment Practices of Insurance Companies	444	(1)
Centers of Excellence and BMT	445	(4)
The Changing Role of Physicians in Managed Care	449	(1)
Risk Sharing	450	(2)
The Cost of BMT	452	(1)
Internal-Provider Management of COE Contracts	453	(6)
Cost Reduction Issues	459	(2)
Conclusion	461	(1)
References	461	(2)
Appendix A List of Abbreviations	463	(6)
Appendix B PBSC Equipment Suppliers	469	(4)
Appendix C Discharge Care Pathways	473	(16)
Index	489