Veno-occlusive disease nurse management: development of a dynamic monitoring tool by the GITMO nursing group.
Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses' areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not.
Haematology Unit, Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia, Italy.
Stefano
S
Botti
Division of Clinical Haemato-Oncology, Istituto Europeo di Oncologia, Milan, Italy.
Laura
L
Orlando
Haematology and BMT Unit, AOU Federico II Napoli, Naples, Italy.
Gianpaolo
G
Gargiulo
Paediatric Haemato-Oncology Unit, Policlinico S Matteo Pavia, Viale Camillo Golgi, 19, 27100 Pavia PV, Italy.
Valentina De
VD
Cecco
BMT Unit, Ospedale Maggiore IRCCS Milano, Milan, Italy.
Marina
M
Banfi
Haematology and BMT Unit, Ospedale Silvestrini, Perugia, Italy.
Lorenzo
L
Duranti
BMT Unit, Spedali Civili di Brescia, Brescia, Italy.
Emanuela
E
Samarani
SODc Paediatric Tumours and BMT Unit, Ospedale Pediatrico Meyer Firenze, Florence, Italy.
Maria Giovanna
MG
Netti
Paediatric Haematology/Oncology Department, IRCCS G Gaslini, Genova, Italy.
Marco
M
Deiana
BMT Unit, Spedali Civili di Brescia, Brescia, Italy.
Vera
V
Galuppini
Quality Office, Istituto Regina Elena Rome Transplant Network, Rome, Italy.
Adriana Concetta
AC
Pignatelli
BMT Unit, Spedali Civili di Brescia, Brescia, Italy.
Rosanna
R
Ceresoli
Paediatric Haemato-Oncology and BMT Unit, Azienda Ospedaliera di Padova, Via Nicolò Giustiniani, 2, 35128 Padova PD, Italy.
Alessio
A
Vedovetto
Paediatric Haematology/Oncology and BMT Department, Azienda Ospedaliero, Universitaria S Orsola Malpighi, Bologna, Italy.
Elena
E
Rostagno
Paediatric Haemato-Oncology and BMT Unit , Ospedale Regina Margherita, Torino, Italy.
Marilena
M
Bambaci
Paediatric Haematology/Oncology Department, IRCCS G Gaslini, Genova, Italy.
Cristina
C
Dellaversana
Haematology Unit, Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia, Italy.
Stefano
S
Luminari
Haematology and BMT Unit, Azienda Ospedaliero, Universitaria S Orsola Malpighi, Bologna, Italy.
Francesca
F
Bonifazi
assessment; monitoring; nurse management; stem cell transplantation; veno-occlusive disease