A national survey of infection prevention practices on bone marrow transplant units.

PURPOSE/OBJECTIVES: To identify and describe bone marrow transplant (BMT)-specific infection prevention measures in the United States. DESIGN: Survey design using a mailed questionnaire. SETTING: BMT programs across the United States. SAMPLE: 91 BMT programs (80.5% response rate). METHODS: A questionnaire containing both closed- and open-ended items was mailed to identified nurse contacts following introductory phone calls. Descriptive statistics were computed on responses to closed-ended questions; content analysis was performed on responses to open-ended questions. FINDINGS: Although all programs used some type of protected environment, practices varied considerably. Wide variation existed in cover-garment and hand-washing practices, regardless of the type of protected environment in use. Other protective measures included skin decontamination (69%), gut decontamination with oral nonabsorbable antibiotics (30%), antifungal therapy (73%), acyclovir therapy (82%), immunotherapy (73%), granulocyte-macrophage colony stimulating factor therapy (58%), and modified microbial diets (66%). Numerous mouth care regimens, visitor and patient precautions, and environmental maintenance routines were described. CONCLUSION: Little standardization of infection-prevention practices exists nationwide. IMPLICATIONS FOR NURSING PRACTICE: Efforts should be made to test the cost effectiveness and benefits of the various measures in use prior to the development of national standards.