Stefano Botti1, Iris Agreiter2, Laura Orlando3, Gianpaolo Gargiulo4, Francesca Bonifazi5, Marina Marialuisa Banfi6, Lorella Cappucciati7, Cristiana Caffarri8, Valentina De Cecco9, Giuseppe Marco Deiana10, Marta Gavezzotti11, Antonio Magarò12, Maria Giovanna Netti13, Adriana Concetta Pignatelli14, Elena Rostagno15, Emanuela Samarani16, Janini Silva Cardoso8, Sonia Soave17, Concetta Maria Valente16, Alessio Vedovetto18, Marco Zecca9, Stefano Luminari8, Francesco Merli8, Monica Guberti19. 1. Haematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy. stefano.botti@ausl.re.it. 2. Bone Marrow Transplant Unit Denis Burkitt, St. James's Hospital, Dublin, Ireland. 3. Bone Marrow Transplant Unit, Istituto Oncologico Svizzera Italiana, Bellinzona, Switzerland. 4. Haematology Unit, Federico II University Hospital of Naples, Naples, Italy. 5. Institute of Haematology "Seràgnoli", University Hospital S. Orsola-Malpighi, Bologna, Italy. 6. Bone Marrow Transplant Unit, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico and University of Milan, Milan, Italy. 7. Department of Haematology, Guglielmo da Saliceto Hospital Piacenza, Piacenza, Italy. 8. Haematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy. 9. Paediatric Haematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. 10. Paediatric Haematology/Oncology Department, IRCCS G. Gaslini, Genoa, Italy. 11. Haematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 12. Division of Haemato-oncology, European Institute of Oncology Milan, Milan, Italy. 13. Department of Pediatric Oncology, Neuro-Oncology Unit, Meyer Children's University Hospital Florence, Florence, Italy. 14. Department of Haematology, Regina Elena National Cancer Institute, Rome, Italy. 15. Paediatric Haemato-oncology and BMT Department, Azienda Ospedaliero, Universitaria S. Orsola Malpighi, Bologna, Italy. 16. Adult BMT Unit, ASST Spedali Civili Brescia, Brescia, Italy. 17. Stem Cell Transplant Unit, Department of Hematology, Tor Vergata "University Hospital" Rome, Rome, Italy. 18. Health Profession Direction, Nursing Course University of Padova, Padua, Italy. 19. Health Professions Direction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
Abstract
PURPOSE: Sinusoidal obstruction syndrome (SOS) is one of the most serious complications post haematopoietic stem cell transplantation (HSCT). The diagnosis of SOS is clinical, but nurses should be involved in the pre-transplant risk assessment period and play a crucial role in the early detection of signs and symptoms during and after hospitalization. The aim of this work is to achieve a consensus on nurses' behaviour in caring for SOS. METHODS: On behalf of the Italian Group for Bone and Marrow Transplantation (GITMO), a promoter committee was established to put in place a consensus conference approach. A multidisciplinary group of GITMO together with four nurses, three haematology physicians and one patient representative acted as jury, who reviewed the reports and wrote recommendations and suggestions. Recommendations gaining 100% of consensus were considered 'Golden Points of Care'; if a consensus was achieved by ≥ 75% of the jury's members, those recommendations were defined as 'Good Practices'. RESULTS: Eighteen papers written by nurses as first authors have been identified. Golden Points of Care and Good Practices were worked out for the following topics: nurses' role in general, nurses' role in pre-transplant assessment, pre-transplant risk assessment and risk stratification, baseline monitoring, suspected mild or moderate SOS, suspected severe or very severe SOS and late-onset cases. CONCLUSION: SOS is relatively rare; therefore, a holistic approach to the patients' needs considering nursing role as essential may result in better care outcomes.
PURPOSE:Sinusoidal obstruction syndrome (SOS) is one of the most serious complications post haematopoietic stem cell transplantation (HSCT). The diagnosis of SOS is clinical, but nurses should be involved in the pre-transplant risk assessment period and play a crucial role in the early detection of signs and symptoms during and after hospitalization. The aim of this work is to achieve a consensus on nurses' behaviour in caring for SOS. METHODS: On behalf of the Italian Group for Bone and Marrow Transplantation (GITMO), a promoter committee was established to put in place a consensus conference approach. A multidisciplinary group of GITMO together with four nurses, three haematology physicians and one patient representative acted as jury, who reviewed the reports and wrote recommendations and suggestions. Recommendations gaining 100% of consensus were considered 'Golden Points of Care'; if a consensus was achieved by ≥ 75% of the jury's members, those recommendations were defined as 'Good Practices'. RESULTS: Eighteen papers written by nurses as first authors have been identified. Golden Points of Care and Good Practices were worked out for the following topics: nurses' role in general, nurses' role in pre-transplant assessment, pre-transplant risk assessment and risk stratification, baseline monitoring, suspected mild or moderate SOS, suspected severe or very severe SOS and late-onset cases. CONCLUSION:SOS is relatively rare; therefore, a holistic approach to the patients' needs considering nursing role as essential may result in better care outcomes.
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