Bone marrow transplantation: issues for critical care nurses

Core competencies for bone marrow transplantation nurse practitioners

The role of the bone marrow transplantation nurse practitioner (BMT NP) has been implemented in most major academic transplantation centers; however, little literature supports the scope of practice and core competencies in this setting. With an increasing shortage of oncologists, opportunities exist for BMT NPs to become leaders in the clinical management of BMT recipients. This article reviews the literature and current professional guidelines to develop core professional and clinical competencies for BMT NPs.

Hematopoietic stem cell transplantation: implications for critical care nurses

Hematopoietic stem cell transplantation (HSCT) is being used increasingly in the treatment of malignant and nonmalignant diseases. The treatment modality has been proven effective but is not without risks. Studies consistently have identified the need for advanced supportive care (e.g., multiple organ dysfunction, vasopressor use, mechanical ventilation) as a negative prognostic indicator in patients who have received HSCT. Among patients who have received HSCT, 15%-40% require critical care monitoring or advanced support. Nurses on intensive care units can positively impact outcomes for transplant recipients when they possess the specialized skills to recognize and promptly intervene when transplant-related complications arise. This article will provide a basic overview of the HSCT process and outline the complications that may necessitate transfer to a higher level of care for specialized skills and equipment in the intensive care setting.