2.50
Hdl Handle:
http://hdl.handle.net/10755/164790
Category:
Abstract
Type:
Presentation
Title:
Guidelines for Obtaining Busulfan Levels
Author(s):
Privitere, Lisa; Kumpf, Rose; West, Kathy
Author Details:
Lisa Privitere, RN, OCN, Nurse Administrator, Roswell Park Cancer Institute, Buffalo, New York, USA, email: lisa.privitere@roswellpark.org; Rose Kumpf, RN; Kathy West, PharmD
Abstract:
Clinical/Evidence Based Practice: Busulfan is a Chemotherapy medication that is administered as part of preparative regimen for Blood and Marrow Transplants. The only way for the physician to determine how well the medication was being metabolized by the body was to obtain many serum samples at different times after administration of the first prescribed Busulfan dose. The BMT Busulfan curves were evaluated for accuracy and found to be outside the normal curve outline. As a result of the evaluation it was determined that a complete redesign of the Busulfan blood-draw tool was needed. In addition a further evaluation determined that the staff nurses could substantially improve their blood drawing techniques and practices through updated and revised educational measures and tools. The Nurse Administrators for the BMT service identified this as a Quality Improvement (QI) project and developed a multifaceted remediation program to address the problems identified. In particular the blood draw tool was completely redesigned to address the correct time frames needed to achieve the requisite and projected Busulfan curve. Observations of the nurses as they administered the Busulfan and prepared for blood draws provided the platform for correction of their actions: coaching and guidance occurred at the time of actual performance. All nurses involved with the administration and monitoring levels of the drug went through the remediation process: these included nurses from two inpatient clinical sites. The results of subsequent Busulfan levels were well within the projected curve expectations and have remained 100% compliant since the implementation of the remediation program. The monitoring process remains a standard of the QI program for the BMT unit. All results are reviewed by the Pharm-D and the Physician and drug dosing is effectively adjusted for maximum patient outcome. The blood levels obtained since the implementation of this program are now deemed as reliable. A surprising result was noted that the pediatric population metabolizes Busulfan much faster than do adults: thus they require a larger dose than would be expected according to their weight. The competent techniques and practices of staff nurses continue to be monitored.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2009
Conference Name:
34th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Antonio, Texas, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleGuidelines for Obtaining Busulfan Levelsen_GB
dc.contributor.authorPrivitere, Lisaen_US
dc.contributor.authorKumpf, Roseen_US
dc.contributor.authorWest, Kathyen_US
dc.author.detailsLisa Privitere, RN, OCN, Nurse Administrator, Roswell Park Cancer Institute, Buffalo, New York, USA, email: lisa.privitere@roswellpark.org; Rose Kumpf, RN; Kathy West, PharmDen_US
dc.identifier.urihttp://hdl.handle.net/10755/164790-
dc.description.abstractClinical/Evidence Based Practice: Busulfan is a Chemotherapy medication that is administered as part of preparative regimen for Blood and Marrow Transplants. The only way for the physician to determine how well the medication was being metabolized by the body was to obtain many serum samples at different times after administration of the first prescribed Busulfan dose. The BMT Busulfan curves were evaluated for accuracy and found to be outside the normal curve outline. As a result of the evaluation it was determined that a complete redesign of the Busulfan blood-draw tool was needed. In addition a further evaluation determined that the staff nurses could substantially improve their blood drawing techniques and practices through updated and revised educational measures and tools. The Nurse Administrators for the BMT service identified this as a Quality Improvement (QI) project and developed a multifaceted remediation program to address the problems identified. In particular the blood draw tool was completely redesigned to address the correct time frames needed to achieve the requisite and projected Busulfan curve. Observations of the nurses as they administered the Busulfan and prepared for blood draws provided the platform for correction of their actions: coaching and guidance occurred at the time of actual performance. All nurses involved with the administration and monitoring levels of the drug went through the remediation process: these included nurses from two inpatient clinical sites. The results of subsequent Busulfan levels were well within the projected curve expectations and have remained 100% compliant since the implementation of the remediation program. The monitoring process remains a standard of the QI program for the BMT unit. All results are reviewed by the Pharm-D and the Physician and drug dosing is effectively adjusted for maximum patient outcome. The blood levels obtained since the implementation of this program are now deemed as reliable. A surprising result was noted that the pediatric population metabolizes Busulfan much faster than do adults: thus they require a larger dose than would be expected according to their weight. The competent techniques and practices of staff nurses continue to be monitored.en_GB
dc.date.available2011-10-27T12:07:03Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:07:03Z-
dc.conference.date2009en_US
dc.conference.name34th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Antonio, Texas, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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