Date of Completion

8-2024

Document Type

Open Access Project

Degree Name

Doctor of Nursing Practice (DNP)

Faculty Advisor

Joanne Roman Jones, JD, PhD, RN

Site Advisor

Alexandra Dormal, BSN, RN

Second Reader

Joyce Larson, DNP, ANP-BC

Abstract

Background: Chimeric antigen receptor T cell (CAR-T) therapy is a novel and promising cancer treatment for hematologic malignancies. This treatment is highly regulated by the Food and Drug Administration (FDA) and The Foundation for the Accreditation of Cellular Therapy (FACT) because of the known toxicities associated with treatment.

Local problem: In 2022, FACT published guidelines requiring formal education for both oncology and non-oncology nurses who care for these patients, including emergency room and intensive care unit nurses.

Methods: This quality improvement project provided education to emergency room and intensive care unit care nurses who are caring for CAR-T cell therapy patients using synchronous and asynchronous education sessions.

Interventions: This quality improvement project focused on providing education to emergency room and intensive care unit nurses caring for CAR-T cell therapy patients outside of the oncology unit regarding documentation and identification of Cytokine Release Syndrome (CRS) and Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS), grading of toxicities, and subsequent triage, and appropriate interventions according to clinical guidelines published by the American Society for Transplantation and Cellular Therapy.

Results: In total, 141 staff from the medical intensive care unit and emergency room completed the education and post-survey. Pre and post intervention survey results showed an increase in learner knowledge and skill in CAR-T cell therapy, CRS, and ICANS. There was not a substantial difference between learner outcomes when synchronous and asynchronous learning was compared. Continuing education opportunities were identified from the post data survey.

Conclusion: Both synchronous and asynchronous education are an effective means of proving education. However, when given the option, more learners chose to participate in synchronous education rather than asynchronous. Both methods should be offered to learners in the future and embedded into unit orientation.

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