Tia Wheatley, DNP, RN, AOCNS, BMTCN, and Shivani Gopalsami, RN, MSN, ANP-BC, AOCNP, discuss the benefits and challenges of multidisciplinary collaboration in hematopoietic stem cell transplant care.
Tia Wheatley, DNP, RN, AOCNS, BMTCN, a certified clinical nurse specialist for the hematology/oncology and cellular therapy program, and Shivani Gopalsami, RN, MSN, ANP-BC, AOCNP, a hematology/oncology nurse practitioner supervisor, both with UCLA Health, sit down with Oncology Nursing News® to discuss multidisciplinary approaches to hematopoietic stem cell transplant care. The duo presented on the topic during the 48th Annual Oncology Nursing Society (ONS) Congress.
As Wheatley explains, different professionals across the oncology care team bring a different lens to different quality improvement initiatives. Collaboration between the nurse practitioner (NP), doctor of pharmacy (PharmD), and clinical nurse specialist (CNS) can therefore increase the utility and effectiveness of new initiatives.
One successful initiative that Wheatley and Gopalsami helped roll out at their own institution was the electrolyte replacement protocol (ERP). Gopalsami explains that, previously, when patients required replacements for their medications, the nurses needed to reach out to providers for the orders. However, the ERP allows for the nurses to provide these medications when clinically indicated. It also promotes the timely administration of magnesium and potassium.
To develop the ERP, Wheatley, a CNS, conducted a literature review of outpatient oncology and intensive care unit protocols. Gopalsami, an NP, detailed the appropriate patient doses and parameters for treatment, and the PharmD ensured that the necessary medications were available to the nurses through the Pyxis.
Ultimately, the team successfully reduced the time from laboratory results to medication administration from 6 hours to 1.5 hours.1
Wheatley explains that the NP, PharmD, and CNS all conduct daily rounds together, which allows them to see patients’ needs from each of their unique perspectives.
“I think having all of those perspectives makes us more comprehensive in the care that we're providing,” she says. “There are a lot of barriers to [multidisciplinary care]. It is definitely not something that happens overnight…but I think as we have gotten more of a hang on it and showed how this collaborative work is impacting patient outcomes, we have had a lot of buy in for other initiatives to where a lot of those barriers have actually been mitigated,” she concludes.
Gopalsami S, Wheatley T, Kim C. Improving hematopoietic stem cell transplant patient outcomes utilizing interdisciplinary collaboration between pharmacy and advanced practice nursing. Presented at: 48th Annual Oncology Nursing Society Annual Congress; April 27-May 1, 2023; San Antonio, TX. Accessed May 12, 2023. Abstract O6. https://ons.confex.com/ons/2023/meetingapp.cgi/Paper/13235