Management of dermatologic complications of chronic graft versus host disease: a case study.

The purpose of this article is to illustrate a multidisciplinary team collaborative approach to the management of dermatologic complications related to chronic graft versus host disease (GVHD). GVHD is a complication of allogeneic bone marrow transplantation (BMT) and peripheral blood cell transplantation (BCT). The skin is affected in more than 80% of patients with chronic GVHD who received a BMT. Involvement can be limited or extensive and can seriously affect patient morbidity and mortality. Nursing care of the patient with chronic GVHD induces careful patient assessment, patient and family education, and interventions aimed at preventing or minimizing complications. A coordinated multidisciplinary team approach is essential for the successful management of chronic GVHD. Nurses play a critical role in coordinating the multiple disciplines involved in the care of patients with chronic GVHD.

Nursing care of the blood cell transplant recipient.

OBJECTIVES: To review the complications of blood cell transplantation (BCT) and their clinical and nursing management. DATA SOURCES: Review articles, research studies, book chapters pertaining to the complications of peripheral stem cell transplantation and the management of these complications. CONCLUSIONS: As the number of patients receiving BCT increases, complications related to stem cell mobilization, harvesting, dose-intensive conditioning therapy, infusion, and engraftment are being documented with increasing accuracy. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses will be caring for an increasing population of patients undergoing BCT. Although complications of both bone marrow transplantation and BCT are similar there are unique differences. Support and nursing interventions are of utmost importance for BCT patients and their family caregivers.

Delayed complications of bone marrow transplantation: an update.

PURPOSE/OBJECTIVES: To review the delayed complications of bone marrow transplantation (BMT) with respect to specific problems, prognoses, causes, times of onset, and medical and nursing management. DATA SOURCES: Books, chapters, published professional articles, computerized data bases, and proceedings of national meetings. DATA SYNTHESIS: BMT, a life-saving measure for many patients with cancer, is associated with serious delayed complications. Morbidity and mortality from multisystem chronic graft-versus-host disease (GVHD), severe immunosuppression, sterility, growth and development problems, cataracts, relapse, secondary malignancies, and other complications can occur 100 days or more after BMT. Complications result from the effects of high-dose conditioning regimens, GVHD, transplant-related problems, and disease relapse. CONCLUSIONS: BMT is a life-saving measure associated with complications that can occur months to years after transplantation. Considerable research is needed to improve treatment for these complications and to increase the length of disease-free, long-term survival. IMPLICATIONS FOR NURSING PRACTICE: Nurses working with patients before and after BMT can be instrumental in managing long-term complications. Preparation of patients and families prior to, during, and after BMT can help alleviate anxieties throughout the continuum of recovery. Since the population of patients who have undergone BMT is growing, nurses in community and ambulatory settings need to include evaluation for physical and psychological sequelae of BMT as part of routine assessment, and symptom management as part of standard care.

Nursing salaries and practice patterns: a nationwide evaluation by the Oncology Nursing Society.

This article summarizes the results of a national survey of salary, staffing, and professional practice patterns in oncology nursing conducted by the Oncology Nursing Society. The respondents represent a wide geographic distribution, and data were analyzed in the aggregate, as well as by American Hospital Association (AHA) regions, to allow for predictions of regional as well as national trends. This article reports on national and regional trends in salaries for entry-level and experienced practitioners; salary patterns for agency and float pool nurses; and the methods for awarding salary increases to nursing personnel in the past year. National trends in a variety of personnel practices affecting oncology nursing (e.g., shifts, self-scheduling, tuition reimbursement, and certification) are also presented. The data in this study come from a broad-based and geographically well-distributed sample that allows for meaningful national comparisons.

Bone marrow transplantation.

Bone marrow transplantation for treatment of certain hematologic and nonhematologic diseases is rapidly becoming the treatment of choice for a large number of patients. Over 10,000 marrow transplants have been performed, and over 200 marrow transplant units currently exist. Complex medical and nursing care from marrow transplant teams is required to care for the acute and chronic complications associated with this treatment. This article addresses the history and process of marrow transplantation and nursing assessments and the interventions needed to care for marrow recipients, their donors, and their families.