Intravenous immunoglobulin administration: an evaluation of vital sign monitoring.
OBJECTIVE
To determine if adverse reactions to IV immunoglobulin G (IVIG) were being detected by nurses and frequent vital sign monitoring.


METHODS
Retrospective chart review.


METHODS
Bone marrow transplant (BMT), medical oncology, and pediatric units and the outpatient clinic of a 720-bed hospital in middle Tennessee.


METHODS
62 charts of patients undergoing BMT who had received IVIG. METHODS/MAIN RESEARCH VARIABLES: Charts were reviewed for patient demographics, number and type of IVIG infusion, incidence of adverse reactions, and related information.


RESULTS
Nine reactions were documented out of 731 separate infusions. Only three reactions could be linked directly to IVIG infusion. Of the nine reactions, only four were detected by nursing personnel during vital sign monitoring.


CONCLUSIONS
Nursing time devoted to frequent vital sign assessment does not seem to be warranted. Protocol for administration and monitoring of IVIG at this institution was changed to reflect these findings.


CONCLUSIONS
Frequent vital sign monitoring is advised for the initial IVIG dose. If no adverse reactions occur, only baseline vital sign monitoring is advised for subsequent infusions. Patients are taught to recognize and report symptoms of adverse reactions.
Camp-Sorrell
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Myelosuppression Unit, Vanderbilt University Medical Center, Nashville, TN.
Wujcik
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D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000451:nursing*; D002985:Clinical Protocols; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009730:Nursing Assessment; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D012189:Retrospective Studies; D013997:Time Factors; D016526:Workload
D016756:Immunoglobulins, Intravenous