Bone Marrow Transplant Program
The Adult Blood and Bone Marrow Transplant Program (BMT) is located on the seventh floor of the UF Health Shands Cancer Hospital and consists of an inpatient unit, outpatient clinic, apheresis facilities and stem cell laboratory.
The inpatient unit has 24 private rooms with continuous cardiac and pulse oximetry monitoring capability at each bedside. The program also includes an adjacent outpatient clinic, providing care for both the pre- and post-BMT phase. The outpatient clinic consists of examination rooms for treatments and procedure, an infusion room, four apheresis stations and a stem cell lab.
Current hours of operation for the clinic are Monday through Friday from 8:00 a.m. to 4:30 p.m. and weekend hours are based on patient needs. Average bed occupancy on the inpatient unit is 88%. The outpatient unit maintains an average of 600 visits per month and approximately 25 apheresis procedures per month.
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Patients are admitted from admissions as scheduled appointments, BMT outpatient clinic, the emergency department and as hospital-to-hospital referrals. Patients are admitted to the unit for stem cell transplants, pre- and post- transplant complications and chemotherapy. Types of transplants include: autologous, syngeneic, allogeneic or matched-unrelated donor (MUD) transplants in the form of cord blood, peripheral blood stem cells (PBSC) or bone marrow. Patients are treated for a variety of hematological, oncological, immunological, malignant and metabolic disorders. The population includes patients 14 and older. The average length of stay is 15.4 days.
Nursing care is directed toward prevention and treatment of bone marrow transplant complications by focusing on assessment, nursing diagnosis outcome identification, planning, treatment and evaluation of patients requiring inpatient care. Nursing care activities include comprehensive care of all body systems, assessment and treatment of comfort (pain, nausea/vomiting, temperature imbalance), treatment of fluid and electrolyte abnormalities, administration and management of intensive medication therapies (antibiotics, antivirals, antifungals, growth factors, chemotherapy, immunoglobulins ,immunosuppressants, biological response modifiers and blood products) and early intervention and treatment of common complications/side effects of transplant including mucositis, bowel changes, myelosuppression, graft versus host disease, hemorrhagic cystitis, veno-occlusive disease, tumor lysis syndrome and sepsis. Nurses also provide ongoing education for the patient and their family and caretakers.
The BMT medical director is appointed by the chief of hematology/oncology division. The medical director is board-certified in medical oncology. The department of hematology/oncology/BMT service consists of attending physicians, fellows, physician assistants and nurse practitioners. Patients are cared for by a multidisciplinary team consisting of the medical team (physicians and midlevel providers), registered nurses, patient care assistants, transplant coordinators, pharmacists, respiratory therapists, physical therapists, occupational therapists, social workers, registered dieticians, chaplains, patient and family services representatives and the Arts-in-Medicine program. Collaboration is fostered by weekly referral meetings attended by medical staff, nurses, pharmacists, protocol/research nurses and transplant coordinators. There are also multidisciplinary daily rounds on the inpatient unit.
The nursing management structure consists of a nurse manager with one inpatient and one outpatient clinical nurse leader. Registered nurses and patient care assistants provide bedside nursing care. Unit clerks provide clerical support for the direct patient caregivers. The registered nurse is responsible for guiding care of the patient based upon their individualized plan.