Training nurses in the administration of CAR T-cell (CAR-T) infusions and management of postinfusion care can broaden oncology nurse knowledge and competency, according to a poster presentation at the 48th Annual Oncology Nursing Society (ONS) Congress.
As the COVID-19 pandemic continued, the dedicated hematopoietic stem cell transplantation (HSCT) unit at a major medical center was faced with a problem: it was not set up to accommodate patients with COVID, due to HEPA filtration and the inability to change rooms to negative pressure.
Therefore, a team of HSCT nurses developed an educational intervention to prepare oncology nurses on another unit to care for patients undergoing CAR-T therapy who were also COVID positive so as not to delay their treatment, which would put them at risk for relapse.
The intervention included multiple education sessions. The first sessions took place during in-person morning huddles and focused on CAR-T management, including education about chemotherapy, cell administration, emergencies, and patient monitoring postinfusion. Additional components of the intervention included a nursing grand rounds lecture, the designation of a nurse as unit champion, and mandatory risk evaluation and mitigation training as required by the US Food and Drug Administration.
Prior to the intervention, the participating nurses were assessed for knowledge gaps with a 10-question electronic questionnaire. They were assessed again afterward. The nurses in charge of the intervention delivered follow-up education to address any gaps. The participating nurses also underwent evaluation for confidence in managing CAR-T therapy, and their confidence levels were determined to have risen over the course of the intervention.
Ultimately, the intervention was considered a success. “Upskilling the 10 North nursing team resulted in the successful administration of 10 CAR-T transplants in 2022,” the authors wrote as part of their presentation. “As of September 2022, the CAR-T program at New York Presbyterian has surpassed 2021 CAR-T administrations, with 37 CAR-T transplants year-to date.”
Additionally, the authors noted, the nurses who completed the training are able to provide orientation for new hires with the education that they received.
Ahearn P, Roselli T. Upskilling oncology nurses to competency with CAR-T infusion & management. Poster presentation at: 48th Annual ONS Congress; April 26-30, 2023; San Antonio, TX.