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‘Empowered’ Nurses Cut Respiratory Infections in BMT Unit

‘Empowered’ Nurses Cut Respiratory Infections in BMT Unit

WASHINGTON—For
patients undergoing bone marrow transplant (BMT), viral respiratory infections
can prove fatal. Viral respiratory infection was a contributing factor in two
patient deaths during a 17-case viral respiratory outbreak among the staff,
patients, and family members of a BMT unit, said Leslie D. Wehrlen, RN, BSN,
OCN, clinical research nurse, Clinical Cancer Nursing Department, National
Institutes of Health (NIH).

Soon after the outbreak, a multidis-ciplinary team of
physicians, nurses, and pharmacists from the medical center’s BMT, infectious
disease, occupational medicine, and epidemiology services began work on new
infection control standards to prevent any recurrence of such an outbreak, she
reported at the 27th Annual Congress of the Oncology Nursing Society (abstract
61).

Under the procedures in effect at the time of the 17-case
outbreak, patients generally were placed in respiratory isolation only after a
positive culture had established the presence of a viral infection. Patients
and their families received only limited formal education on avoiding upper
respiratory infections. Patients also sat in large waiting rooms that increased
the risk of exposure.

The New Strategy

The new prevention strategy led to an immediate change in
practice. Respiratory isolation now begins as soon as symptoms of infection
appear. In addition, patients, family, and staff all receive intensive training
on recognizing symptoms of respiratory infection, preventing their spread, and
managing viral illnesses. Family members learn of the importance of not
transmitting infections either at home or in the BMT unit.

Signs in both English and Spanish posted at the unit’s
entrance warn visitors to be aware of viral symptoms and avoid visiting should
any be present. In addition, steps were taken to obtain culture results more
rapidly.

Staff are offered free flu vaccinations and instructions to
monitor themselves carefully for symptoms. Should flu-like symptoms appear, the
staff members may receive treatment with medicines such as oseltamivir
phosphate (Tamiflu).

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