Nursing management of haemorrhagic cystitis in patients undergoing haematopoietic stem cell transplantation: A multicentre Italian survey

Chiara Visintini, Margherita Venturini, Stefano Botti, Gianpaolo Gargiulo, Alvisa Palese

Research output: Contribution to journalArticle

Abstract

Background: Haemorrhagic cystitis (HC) is a severe complication occurring after haematopoietic stem cell transplantation (HSCT) in 13-40% of patients, caused by infectious and/or non-infectious factors that increase the in-hospital length of stay and the risk of mortality of transplanted recipients. Although different management interventions have been suggested in the literature, available knowledge on interventions performed by Italian nurses in their daily practices has not been documented to date. Aim of the study: The aim of this study is to describe HC preventive and treatment interventions in patients undergoing HSCT as performed by Italian nurses in their daily practice. Material and methods: A multicentre survey was conducted in 2018 by inviting all 110 Italian HSCT centres belonging to the Italian Group for Bone Marrow Transplantation (GITMO). Data collection was performed with an online questionnaire submitted to GITMO reference nurses working in each HSCT centre. Descriptive statistics were performed. Results: A total of 38 Italian centres participated. The preventive intervention most applied in daily care was the mesna administration (n=37; 97.4%), followed by intravenous hyperhydration (n=33; 86.8%) and forced diuresis with furosemide (n=24; 63.1%). Preventive continuous bladder irrigation (CBI) was performed in 13 centres (34.2%). Transfusions of blood products (n=32; 84.2%), CBI (n=31; 81.6%) and intravenous hydration (n=28; 73.7%) were the most applied treatments, beyond the administration of analgesics (n=38; 100.0%) and antispasmodics (n=26; 68.4%). Conclusion: A great variability both in the HC prevention and treatment interventions applied in daily practice across centres have emerged suggesting that no strong recommendations in the field are available to date. Therefore, there is a need to increase the evidence available in the field by providing methodological studies of higher quality, multicentre and prospective.

Original languageEnglish
Article numbere2019051
JournalMediterranean Journal of Hematology and Infectious Diseases
Volume11
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Cystitis
Hematopoietic Stem Cell Transplantation
Nursing
Nurses
Length of Stay
Urinary Bladder
Mesna
Parasympatholytics
Diuresis
Furosemide
Bone Marrow Transplantation
Blood Transfusion
Analgesics
Therapeutics
Mortality
Surveys and Questionnaires

Keywords

  • Haematopoietic stem cell transplantation
  • Haemorrhagic cystitis
  • Italy
  • Management
  • Nursing
  • Prevention
  • Professional experience
  • Supportive measures
  • Survey
  • Treatment

ASJC Scopus subject areas

  • Hematology
  • Infectious Diseases

Cite this

Nursing management of haemorrhagic cystitis in patients undergoing haematopoietic stem cell transplantation : A multicentre Italian survey. / Visintini, Chiara; Venturini, Margherita; Botti, Stefano; Gargiulo, Gianpaolo; Palese, Alvisa.

In: Mediterranean Journal of Hematology and Infectious Diseases, Vol. 11, No. 1, e2019051, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Background: Haemorrhagic cystitis (HC) is a severe complication occurring after haematopoietic stem cell transplantation (HSCT) in 13-40{\%} of patients, caused by infectious and/or non-infectious factors that increase the in-hospital length of stay and the risk of mortality of transplanted recipients. Although different management interventions have been suggested in the literature, available knowledge on interventions performed by Italian nurses in their daily practices has not been documented to date. Aim of the study: The aim of this study is to describe HC preventive and treatment interventions in patients undergoing HSCT as performed by Italian nurses in their daily practice. Material and methods: A multicentre survey was conducted in 2018 by inviting all 110 Italian HSCT centres belonging to the Italian Group for Bone Marrow Transplantation (GITMO). Data collection was performed with an online questionnaire submitted to GITMO reference nurses working in each HSCT centre. Descriptive statistics were performed. Results: A total of 38 Italian centres participated. The preventive intervention most applied in daily care was the mesna administration (n=37; 97.4{\%}), followed by intravenous hyperhydration (n=33; 86.8{\%}) and forced diuresis with furosemide (n=24; 63.1{\%}). Preventive continuous bladder irrigation (CBI) was performed in 13 centres (34.2{\%}). Transfusions of blood products (n=32; 84.2{\%}), CBI (n=31; 81.6{\%}) and intravenous hydration (n=28; 73.7{\%}) were the most applied treatments, beyond the administration of analgesics (n=38; 100.0{\%}) and antispasmodics (n=26; 68.4{\%}). Conclusion: A great variability both in the HC prevention and treatment interventions applied in daily practice across centres have emerged suggesting that no strong recommendations in the field are available to date. Therefore, there is a need to increase the evidence available in the field by providing methodological studies of higher quality, multicentre and prospective.",
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