INTRODUCTION OF "QUALIFIED APHERESIS NURSE" CERTIFYING SYSTEM BY THE JAPAN SOCIETY OF TRANSFUSION MEDICINE AND CELL THERAPY TO ENCOURAGE LEARNING AND TO IMPROVE QUALITY OF APHERESIS

Abstract

Background: Apheresis has been conducted for collecting specific types of cellular or plasma components for more than 30 years in Japan. The Japan Marrow Donor Program (JMDP) officially introduced allogeneic peripheral blood stem cell harvest from unrelated donors so that a volunteer donor could select peripheral blood for the stem cell source as well as the bone marrow in 2010. A nationwide survey conducted by the Japan Society of Transfusion Medicine and Cell Therapy (JSTMCT) revealed 1343 and 376 peripheral blood stem cell harvests at 127 and 77 hospitals from patients and related donors, respectively, as of 2011. The Japanese Red Cross Society (JRCS) performed 865,221 platelet and 667,660 plasma collections for transfusions and plasma fractionation products at 165 donation sites in 2012. Aims: In order to cultivate nurses who are familiar with and able to properly practice nursing in apheresis and thereby able to promote the safety of apheresis, through the introduction of JSTMCT-certified Qualified Apheresis Nurse (QAN). Methods: Experts on apheresis among members of the JSTMCT, some of whom also belong to the JMDP, the Japan Society for Hematopoietic Cell Transplantation or the JRCS, were convened to form a council for the JSTMCT-certified QAN. The council formed statutes and bylaws which defined the eligibility for application and the procedures for application, workshops, examination, registration and renewal of the certification. The council compiled a textbook and listed some reference books for selflearning. The council also compiled a DVD video which showed preparative orientation to patients or donors, punctures, monitoring, caring for physical and mental conditions and treatment for adverse events. Nurses eligible for application were required to (i) work at hospitals or blood donation sites operated by the JRCS, (ii) have more than 3 years of clinical experience at hospitals or blood donation sites, (iii) have experience of more than 1 year and 10 cases of apheresis, (iv) get recommended by director of nursing and by physician in charge of transfusion at hospitals or director of blood donation sites. The information was publicized through the official journal, website and dedicated session of annual meetings of the JSTMCT. A questionnaire survey about the attitude of the applicants concerning the QAN-certifying system was conducted after the lecture class and examination. Results: During the 4 fiscal years through 2013, a total of 146 nurses, of whom 54 and 92 belong to hospitals and blood donation sites, respectively, were certified. The questionnaire survey for the nurses who took the lecture class and examination showed the applicants were enthusiastic about learning and improving their skills in apheresis, desired programs for continued education after certification and hoped the certification system to be well acknowledged. Nurses working at blood donation sites felt that it was a good opportunity to learn and think over illnesses, patients and treatments at hospitals which they do not have daily contact with in everyday work. Summary: We have introduced apheresis nurse-qualifying system, which seemed effective to promote self-learning and improve the quality in apheresis for blood products and blood stem cells.