“If you have a question, don’t be afraid to ask the question,” says clinical nurse specialist Dia Byrne. That frame of mind led her to initiate a blood sampling research study at St. Luke’s Mountain States Tumor Institute (MSTI). Her question attracted interest and funding from the national DAISY Foundation.
Byrne was looking for a way to reduce blood loss for patients at St. Luke’s MSTI. “Frequent blood samples are necessary,” she explains, “to monitor the impact of their treatment.” The accepted method for patients with central venous access devices (CVADs) is to discard some of the blood before drawing a sample to go to the lab. The “discard” method assures a sample free of contaminants like saline or heparin but results in blood loss, which may contribute to anemia and increase the need for blood transfusion. Byrne learned about an alternative “push-pull” (mixing) method that has been adopted at other healthcare centers.
The St. Luke’s Iatrogenic Blood Loss task force, on which she serves, was very interested. However, at the time she could find just four published studies, with small samples, that had tested the push-pull method.
“We wanted more robust data,” she said. That’s when she decided to pursue a research study. She found a research mentor in Linda Penwarden, another clinical Nurse Specialist at St. Luke’s MSTI, who helped her design a study using push-pull to draw the first blood sample that would have been discarded. It could then be sent to the lab and compared to the second standard sample to see if both methods produce equivalent results.
Byrne’s next challenge was to find funding for this research project. Last fall, with support from St. Luke’s Research and the System Nursing Research Council, she successfully applied to The DAISY Foundation for a research grant. The DAISY grant covers the costs for the extra lab tests and for data analysis at the end of the study.
“We are very hopeful that her findings will be broadly applicable to patients across the country,” DAISY Foundation co-founder and President Bonnie Barnes said. “The nurse scientists who review applications for our grants believe Ms. Byrne’s well-designed study is an important issue that to date has had limited research investigating it.”
When chemotherapy infusion nurse Stephanie Thompson learned about the study, she volunteered to help. She previously had worked in the Newborn Intensive Care unit, which already uses a method that returns blood to the patients/neonates.
Thompson completed the required training last summer and began collecting the study’s blood samples this fall at St. Luke’s MSTI in Meridian. Patients have been very supportive, she reports. “They don’t have to give any more blood than usual. And it doesn’t cost them anything.” They understand that this technique could save blood for others in the future. Only one qualified patient so far has declined to participate.
“It’s a good feeling,” Thompson says, “to know we are doing what we can to improve healthcare.”