Hematopoietic stem cell transplantation nursing: a practice variation study.
OBJECTIVE
To examine practice variation in hematopoietic stem cell transplantation (HSCT) nursing and to identify the gap between recommended standards of practice and actual practice across settings. Additional practices relevant to HSCT nursing also were explored.


METHODS
Cross-sectional, descriptive survey.


METHODS
National and international cancer centers.


METHODS
A convenience sample was obtained from the 2006 Oncology Nursing Society Blood and Marrow Stem Cell Transplant Special Interest Group membership list (N = 205). Most participants were women (94%) with a median age of 45 years. The primary role was bedside nurse (46%), with an adult-only population (78%) in an academic (84%), inpatient (68%-88%) center. 39 (94%) U.S. states and 7 (6%) non-U.S. countries were represented.


METHODS
Survey development was guided by Dillman Mail and Internet survey design. Electronic questionnaires were conducted with Zoomerang Market Tools.


METHODS
Infection control practices across bone marrow transplantation settings.


RESULTS
Descriptive statistics revealed minimal practice variation regarding infection control across transplantation types or conditioning regimens. Practices regarding implementation of restrictions on patients' hygiene, diet, and social interactions varied by phase of transplantation, with the greatest variations occurring during the post-transplantation phase. Sixty-two percent of respondents reported using published guidelines; 72% reported using organization-specific policies.


CONCLUSIONS
Although published standards are under consideration, practice variation exists across transplantation centers. Whether the variation is caused by a lack of compliance with published guidelines or by the poor delineation of details for providers to translate the guidelines into practice is not known.


CONCLUSIONS
Identifying gaps in the literature and inconsistencies in HSCT practices is an important first step in designing evidence-based projects that can be used to standardize practice and link best practices to improved patient outcomes.
Bevans
Margaret
M
Clinical Center, National Institutes of Health, Bethesda, MD, USA. mbevans@cc.nih.gov
Tierney
D Kathryn
DK
Bruch
Coleen
C
Burgunder
Mary
M
Castro
Kathleen
K
Ford
Rosemary
R
Miller
Michelle
M
Rome
Sandra
S
Schmit-Pokorny
Kim
K
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D018380:Hematopoietic Stem Cell Transplantation / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000628:therapy; D009859:Oncology Nursing / Q000379:methods* / Q000592:standards*; D017410:Practice Guidelines as Topic