Evaluating the effectiveness of a training program to support nurses to administer cryopreserved hematopoietic stem cells by intravenous push method.

Abstract

A training program was developed to prepare registered nurses (RNs) at one cellular therapy centre to administer cryopreserved cells by intravenous (IV) push method. There are two main methods of infusion for dimethyl sulfoxide (DMSO) cryopreserved hematopoietic stem cell (HSC) products, gravity drip and IV push. Administering DMSO by either route can cause hypersensitivity reactions. Administration of HSCs by gravity drip is slower, resulting in fewer DMSO reactions. However, prolonged exposure of DMSO once the cells are thawed increases the risk of cellular damage. The faster IV push method reduces cell damage and decreases staff time. An environmental review within Canadian transplant centres found that in most adult centres, nurses administer by gravity drip, and when IV push is required, cryopreserved hematopoietic stem cells are administered by physicians. Our centre's method was IV push by a physician or nurse practitioner (NP). As transplant numbers grew, capacity to perform this skill needed to expand. To maintain the current benefits of the IV push method and increase capacity in a hematopoietic transplant program, the role of infusing stem cells by the IV push method was transitioned from the NPs and physicians to RNs. A successful training program utilizing simulation to support these oncology nurses in learning the new skill was developed and evaluated.