Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-13-2023

Graduate Advisor

Vanessa Loyd

Co-Advisor

Tonya Haynes

Committee

Samantha Chappell

Abstract

Abstract

Background: Orthostatic hypotension is a potentially serious risk factor that can cause falls in adults, especially those receiving a bone marrow transplant. The odds of falling increase if diagnosed with a hematological form of cancer while receiving treatment due to side effects of chemotherapy and medications.

Methods: This retrospective record review investigated the completion rate of orthostatic vital signs in bone marrow transplant patient’s days 10 to 17. The aim was to discover 2% of positive orthostatic cases in a 6-month period. The primary outcome measures included the number of orthostatic vital signs obtained and secondary outcome measures included the number of falls.

Results: The overall findings included 33 females and 50 males (N=83) in a 6-month period. There were 18 different diagnoses that were treated with 5 different types of bone marrow transplants. In October-December 2022, there was a total compliance rate of 50% and from January-March 2023 there was a compliance rate of 53%. A total compliance rate for a 6-month period of 51%. A chi-square analysis was performed on the data from 2022 vs 2023 and p=.904. The orthostatic compliance was not significantly significant. There were 106 positive orthostatic cases caught which reached the discovery of 2% of cases. There were also 8 total falls, and 3 falls were between the 10 through 17-day timeframe within the 6-month time frame.

Implications for Practice: Overall, the results were not statistically significant, but future PDSA cycles will help to facilitate earlier identification of patients who are orthostatic, prompting timely intervention, and subsequent fall and injury prevention.

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