Tuesday,

J uly 2 1, 2 015 at 3 :23:56 PM M ountain Daylight Time

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TBI Guideline Nursing Informa4on

Tuesday, July 21, 2015 at 3:22:44 PM Mountain Daylight Time
Hendrickson, Mary L
UCH-AIP 11th Onc RN
La Touche, Amiee
11th Floor RNs,

I want to give you guys IMPORTANT informa4on about the nursing care of our Stem Cell Transplant (SCT) pa8ents
who are receiving Total Body Irradia8on (TBI).
I have also aTached the TBI guideline for you to review. Please access this informa4on when caring for a pa4ent
receiving TBI.
The HIGHLIGHTS are:
BEFORE TREATMENT
1. When preparing a patient for radiation, ensure that he/she is not wearing any metal objects including jewelry,
telemetry patches and zippers on clothing (gowns with snaps are okay).
2. As dozens of pa8ents are scheduled for treatment on each machine daily, ensuring that the pa8ent arrives
in the Radia8on Oncology department on 8me prevents treatment delays.
3. If the patient has an early morning appointment, the Radiation Oncology RN will contact the Inpatient RN
the night before to discuss TBI appointments for the next day. If indicated, inform appropriate staff of
isolation precautions in advance.
4. The Inpatient RN will transcribe the patients radiation schedule into the EHR (under the Sticky Note
section) and communicate these times in LOOK report.
5. The Radiation Oncology RN will call to receive report at least 45 minutes before the patients appointment
time. This may be during change of shift.
6. The Inpatient RN will give a brief report on their patient.
7. The Inpatient RN will check MAR and administer ordered pre-medications prior to transporting patient.
8. The Inpatient RN will order transport of patient at least 45 minutes prior to patients appointment.
9. The patient should arrive to the Radiation Oncology department at least 30 minutes BEFORE appointment
time.
10. Explain the procedure to the patient at an appropriate level of understanding.
AFTER TREATMENT
1. Observe for side effects.
2. Administer medications if ordered as needed.
3. Modify nursing care plan for subsequent treatments according to side effects and emotional tolerance of
treatment.
4. Verify in the EHR that TBI is completed prior to infusion of stem cells. (A physician will enter a note in the
EHR after completion of the last TBI dose).

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5. No special radiation precautions will be used after the patient returns from treatment, as the patient will not be
emitting radiation.
Thank you for all the phenomenal care you guys provide for our Bone Marrow Transplant patients! And please let me
know if you have any questions regarding this information.
Sincerely,
Mary Hendrickson, RN, BSN, OCN
Permanent Charge Nurse
Oncology and Bone Marrow Transplant
mary.hendrickson@uchealth.org

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