NURSING MANAGEMENT OF HAEMORRHAGIC CYSTITIS IN PATIENTS UNDERGOING HAEMATOPOIETIC STEM CELL TRANSPLANTATION: A MULTICENTRE ITALIAN SURVEY

Abstract

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 increases the in-hospital length of stay and the risk of mortality of transplanted recipients. Although different management interventions have been suggested in literature, available knowledge on interventions performed by Italian nurses in their daily practices has not been documented to date. Aim of the study: The objective 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 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: There is no gold standard for the prevention and treatment of HC in patients undergoing HSCT, although interventions applied by nurses agree with the literature. There is a need for methodological studies of higher quality, multicentre and prospective, that should focus even on nurses and supportive measures.

Keywords

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