For both allogeneic and autologous HSCTs, a tunnelled CVC or port-a-cath is generally inserted to facilitate administration of the following at various stages of the HSCT as required:
- Conditioning regimen
- Stem cell infusion
- IV drugs such as antibiotics
- Blood products in case of low levels of white blood cells or platelets
- Fluid supplements to address low levels of electrolytes
- Any further chemotherapy as required
- Nutritional support
- For patients undergoing HSCTs, the minimum waiting time required between insertion of a CVC and the start of the conditioning regimen must be factored into the process.Ā
Additionally, patientsā continuing education on how to manage the CVC should be undertaken, focusing particularly on preventing complications.
Nursing staff have a central role in the management of CVCs in HSCT patients including:
- Monitoring of the CVC
- Prevention of complications
- Ongoing education of patients on how to manage their CVC, with a focus on avoiding complications
- Input into determining of the timing for:
- Scheduling the HSCT
- Starting the conditioning regimen
- Optimal length of time for the CVC to remain in placeĀ
- Updating the multidisciplinary healthcare team of any side effects.
