Adult Blood and Marrow Transplant Outpatient Program — Unit 7 East

Several facilities belonging to the Blood and Marrow Transplant (BMT) department are housed on 7 East (7E). 7E is located in the Cancer Hospital on the seventh floor across from the BMT inpatient unit. 7E includes the outpatient acute and chronic clinics, apheresis room, cell processing and storage laboratory, and offices for the BMT referral team, finance team, nurse specialist patient navigation team, and transplant coordinator team.

Patient care areas include three lab draw stations (triage), eight examination rooms, thirteen infusion chairs, four apheresis chairs, two isolation rooms, three observation rooms, and three procedure rooms. 7E is operational seven days a week with full staff Monday through Friday and an attenuated infusion staff on the weekends and holidays.

The BMT department has been continuously accredited by the Foundation for the Accreditation of Cellular Therapy since 2000.

Description of Patient Populations

The BMT program provides treatment for hematologic and malignant diseases. Treatment includes all categories of stem cell transplant including autologous transplant, allogeneic related and allogeneic unrelated transplants, and cord blood transplant, either with peripherally collected or bone marrow harvested stem cell product. The BMT program also provides treatment options that include immerging biotherapies and immune effector cell therapies.

7E provides treatment and transplant workup to pre-transplant patients and serves post-transplant patients who require supportive care following transplant or who have residual or relapsed disease. In addition, 7E provides care for patients on hematology-oncology clinical trial, and 7E provides apheresis services for clinical trials in the neuro-oncology and cardiology DSGs. 7E also provides photopheresis services to BMT patients and lung transplant patients.

Nursing Care

Nursing care in the BMT clinic includes general and focused assessments, specimen collections, blood product transfusions, medication administration including chemotherapy and biotherapy administration, Donor Leukocyte Infusions (DLI), and post-treatment evaluation. Treatment and patient care management encompass chemotherapy-related side effects, disease-related side effects, pancytopenia, transplant-induced complications, infection and sepsis, and supportive care for dehydration and electrolyte imbalance.

The clinic charge nurse assists patient throughput and care delivery and serves as mentor and resource nurse. Unit leadership supports operations planning, efficient and collaborative workflow improvement, quality assurance, and outcome review.

The apheresis nursing team provides cellular collection services, including stem cell collection and lymphocyte collection for chimeric antigen receptor T-cell (CAR-T) and other treatments, and photopheresis treatments indicated for cutaneous T-cell lymphoma, graft versus host disease, and solid organ rejection. Quality outcomes and process improvement are supported by the Apheresis Coordinator, Cell Therapy Quality Specialist, Quality Management Coordinator, and Apheresis Medical Director.

Nurse specialty certification is required within two years of employment in 7E. Competencies are maintained in accordance to hospital and accreditation standards.

Health Care Team

The multidisciplinary healthcare team in 7E includes physicians, advanced practice providers, registered nurses, patient care assistants, cell laboratory technologists, nurse transplant coordinators, pharmacists, social workers, financial specialists, transplant assistants, and data management team members.

The 7E leadership team includes the Director of BMT Operations, Quality Management Coordinator, Clinical Coordinator, Cell Laboratory Coordinator, and Data Management and Registry Systems Coordinator. Medical leadership includes the Program Director, Clinical Medical Director, Apheresis Medical Director, and Laboratory Medical Director.

Staffing Plan

The BMT clinic and apheresis room have a combined staff of 10.9 RN FTEs, 2.1 PCA FTEs, and 1 apheresis technician FTE. Daily staffing is adjusted based on unit census and patient acuity. On most weekdays, the BMT clinic is staffed with 6-8 nurses, and apheresis is staffed with 1-2 nurses. Patient assignments in the BMT clinic are determined by a nationally validated outpatient oncology acuity scale and unit acuity data. The apheresis room maintains a 1:1 nurse/technician to patient ratio with a minimum of one nurse to every one to two patients, which is also based on national benchmarks and patient acuity. Additional nursing support is provided by management, cross trained BMT administrative nurses, and the Central Staffing Office as needed.

Reviewed 1/5/2021

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