Multidisciplinary Bone Marrow Program Prepares Nurses for Aspirations, Biopsies

Registered nurses in a bone marrow program maintained a 98% score for the quality of bone marrow aspiration and biopsy sample.
Registered nurses in a bone marrow program maintained a 98% score for the quality of bone marrow aspiration and biopsy sample.

ORLANDO, FL—Registered nurses who participated in a bone marrow program maintained a 98% score when rated by pathologists for the quality of the bone marrow aspiration and biopsy samples they collected, with no reported incidences of postprocedure complications, according to a presentation at the ONS 40th Annual Congress.

This use of nurse procedurists “demonstrates an innovative partnership for clinical practice, as recommended by the Institute of Medicine (IOM),” said Daravan Kao, RN, BSN, OCN®, of the Seattle Cancer Care Alliance in Seattle, WA.

Results of bone marrow aspiration and biopsies are used to diagnose and evaluate hematologic diseases in general oncology and hematopoietic stem cell transplant patients.

Although these procedures are typically done by physicians or advance practice providers, she said, the IOM's key message confirms that nurses “should practice to the full extent of their education and should be full partners in the redesigning of health care delivery,” a practice confirmed by an advisory opinion from the Washington State Nursing Quality Assurance Commission.

A multidisciplinary team developed and implemented the nurse-led bone marrow aspiration/biopsies program, which included three key elements: didactic training, technical skills acquisition, and ongoing quality assurance.

From January 2012 to June 2013, registered nurses performed 1,975 bone marrow aspiration/biopsy procedures, for a monthly average of 110 cases.

The assurance of quality outcomes for the program was measured using the patient bone marrow quality indicators, with the bone marrow procedures and quality of specimens regularly compiled for each registered nurse procedurist.

“We are pleased to report we have 98% satisfactory quality of aspirated and core biopsies samples and there have been no reported incidences of post-procedure complications,” Grace Steiner, RN, BSN, said during the presentation.

“Use of registered nurse procedurists for BMA/BMX demonstrates the efficacy and consistency in the quality of samples for disease diagnosis and monitoring,” she said.

Steiner concluded, “Future formal observation and data collection is needed to assess patient satisfaction.”

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