Doctor of Nursing Practice
Date of Defense
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.
Tomac, Julianne, "Orthostatic Vital Signs in Bone Marrow Transplant Patients" (2023). Dissertations. 1356.