Instructional Class Improves CAR T-Cell Knowledge in ICU and BMT Nurses

July 16, 2018

Chimeric antigen receptor T-cell (CAR T-cell) therapy has become an integral part of the advancement of lymphoma and other cancer treatments. However, educational resources and available published literature are still lacking for oncology and intensive care nurses.

Wendy Lucas, MSN, RN, CCRN, CCCNS, BMTCN®, and Jamilyn Kennell, MSN, RN, OCN®, of the University of Pittsburgh Medical Center Shadyside Hospital in Pennsylvania, presented information on the need for CAR T-cell education for intensive care unit (ICU) and bone marrow transplant (BMT) nurses and the implementation of an educational immunotherapy class during a poster session at the 43rd Annual Congress in Washington, DC. The poster was titled “CAR T-Cell Education for Intensive Care Unit and Bone Marrow Transplant Nurses.”

The initiative’s objective was to create a four-hour class for ICU and BMT nurses focusing on topics such as the immune system, patient assessment, CAR T-cell complications (e.g., cytokine release syndrome [CRS], neurologic toxicities), appropriate medications, and other available immunotherapies.

Researchers developed the class’s content by researching published articles available on CAR T-cell therapy, reviewing YouTube videos posted by physicians who have used CAR T-cell therapy, and interviewing personnel at other institutions about their experiences with CAR T-cell therapy and their opinions on necessary education.

A total of 82 ICU and MBT nurses attended the class. The class was repeated three times to assess benefit. Pretests were given before the course, and identical post-tests were given at the end of each session to evaluate outcomes.

Results showed that 78% of nurses who attended the educational class and completed both the pretest and post-test improved on their post-tests scores (see Table 1).

Providing this type of immunotherapy education has already shown real-world application benefits. The nurses who attended the class have cared for 13 patients receiving CAR T-cell therapy. Because of the education provided, the nurses were able to recognize specific toxicities, such as CRS and other neurologic adverse reactions, in 9 of the patients. The patients received appropriate interventions from the nurses and were discharged home.

Table 1. Test Score Analysis of Immunotherapy Class

Type of Score

Pre-test

Post-test

Mean

51.7

84.9

Median

50

87

Maximum

100

100

Minimum

12

62


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