Izazovi sestrinstva u skrbi za bolesnika liječenog CAR-T stanicama

master's thesis

• Title (english): Challenges for nurses caring for patients treated with CAR T cells
• Author: Vesna Družinić
• Mentor: Igor Aurer (mentor)
• Committee member: Jasenka Markeljević (predsjednik povjerenstva)
• Committee member: Radovan Vrhovac (član povjerenstva)
• Committee member: Igor Aurer (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-07-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Terapija lijekom tisagenlekleucel, odnosno primjena T limfocita s kimeričnim
receptorom za antigen, CAR–T stanice, pruža novu priliku bolesnicima s određenim
tipovima uznapredovale, refraktorne ili recidivirajuće akutne limfoblastične leukemije i
B-velikostaničnog limfoma, a pred medicinske sestre odjela na kome se liječe postavlja
brojne izazove.
Iako medicinske sestre koje se skrbe za hematološke bolesnike liječene
kemoterapijom i transplantacijom koštane srži imaju znanje, vještine i kompetencije da
pruže sveobuhvatnu skrb bolesnicima koji primaju CAR-T staničnu terapiju, moraju
proći obuku za procjenu i ublažavanje rizika (REMS), kako bi zadovoljile zahtjeve koji
se pred njih postavljaju.
Nova terapija s jedinstvenim nuspojavama, potrebama za procjenom i
dokumentiranjem stanja bolesnika, postupak primjene infuzije CAR-T stanica,
edukacija pacijenta, obitelji ili skrbnika, brzo prepoznavanje hitnih stanja kod bolesnika,
sve su to izazovi s kojima se susrećemo u skrbi za bolesnika liječenog CAR-T
stanicama. Izrada jedinstvene sestrinske dokumentacije za praćenje nuspojava
liječenja je jedan od ključnih sestrinskih izazova koji je omogućio izradu kvalitetnog
plana sestrinske skrbi. Kvalitetnim odgovorom na ove izazove medicinske sestre imaju
jednu od ključnih uloga u ishodu liječenja bolesnika CAR-T stanicama.
Možemo reći da izazovi u skrbi za bolesnika liječenog CAR-T stanicama za medicinske
sestre predstavljaju umijeće sadašnjosti i veliki izazov u budućnosti.

Abstract (english)

Treatment with the drug tisagenlecleucel, i.e. CAR–T cells, offers a new opportunity to
patients with certain types of advanced, refractory or relapsing acute lymphoblastic
leukemia and B-large cell lymphoma and poses multiple challenges to nurses working
on units where these patients are treated.
Despite the fact that nurses caring for hematological patients treated with
chemotherapy and bone marrow transplantation have knowledge, skills and
competencies to offer comprehensive care to patients receiving CAR-T cell therapy,
they have to be trained in risk evaluation and mitigation strategies (REMS) in order to
fulfill the demands placed before them.
This new therapy with unique side-effects, needs for assessment and documentation
of patient's condition, CAR-T cell infusion procedure, education of patients, their
families and caregivers, rapid recognition of medical emergencies in patients, are all
challenges we face in caring for patients treated with CAR-T cells. Creation of a unique
nursing documentation for follow-up of side-effects is one of the main challenges
enabling the creation of a good nursing care plan.
We are therefore justified in stating that challenges in care for CAR-T cells treated
patients represent nursing skills of present and major challenges of the future.

• Keywords: akutna limfoblastična leukemija; CAR-T stanice; difuzni B-velikostanični non-Hodgkin limfom; nuspojave; dokumentacija.
• Keywords (english): acute lymphoblastic leukemia; CAR-T cells; diffuse large B-cell nonHodgkin lymphoma; side effects; documentation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:407368
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-05-10 10:00:39