<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Introduction</h3><p>Switching between clotting factor products is becoming increasingly common as product choice increases and financial pressure grows to choose the most cost-effective options. Guidance on carrying out the switch recommends a complex and long process that may benefit from being defined in a protocol. Haemophilia nurses may be responsible for managing product switches; anecdotal evidence suggests that clinical practice is variable.</p></sec><sec><h3>Aim</h3><p>To explore the role of specialist nurses in switching between clotting factor products and their use of a protocol.</p></sec><sec><h3>Method</h3><p>Nurses attending the 2018 World Federation of Hemophilia Congress were surveyed about clinical practice at their treatment centre and use of a protocol for switching clotting factor products.</p></sec><sec><h3>Results</h3><p>Of 192 nurses attending the conference, 49 nurses returned completed questionnaires, 45 of which were included in the study after exclusions. Responses were exclusively from economically developed countries. Almost all respondents (96%) had direct experience of switching. Half of those who responded to a question about protocol-based switching reported that switches were based on a protocol. When authorship was reported, the protocol was written by haemophilia nurses in about half of cases. Practice about blood testing to determine individual pharmacokinetic parameters prior to the switch was variable, but most nurses (86%) reported screening for inhibitors prior to switching. Respondents agreed to share their protocols among their peers, although only four were received by the research team.</p></sec><sec><h3>Conclusions</h3><p>Clinical practice in switching between clotting factor products is variable. Some nurses are switching treatments for patients without the supported of a written protocol, whereas others are involved in writing and implementing protocols. Sharing protocols is a first step in helping to establish best practice.</p></sec></abstract>

IntroductionSwitching between clotting factor products is becoming increasingly common as product choice increases and financial pressure grows to choose the most cost-effective options. Guidance on carrying out the switch recommends a complex and long process that may benefit from being defined in a protocol. Haemophilia nurses may be responsible for managing product switches; anecdotal evidence suggests that clinical practice is variable.AimTo explore the role of specialist nurses in switching between clotting factor products and their use of a protocol.MethodNurses attending the 2018 World Federation of Hemophilia Congress were surveyed about clinical practice at their treatment centre and use of a protocol for switching clotting factor products.ResultsOf 192 nurses attending the conference, 49 nurses returned completed questionnaires, 45 of which were included in the study after exclusions. Responses were exclusively from economically developed countries. Almost all respondents (96%) had direct experience of switching. Half of those who responded to a question about protocol-based switching reported that switches were based on a protocol. When authorship was reported, the protocol was written by haemophilia nurses in about half of cases. Practice about blood testing to determine individual pharmacokinetic parameters prior to the switch was variable, but most nurses (86%) reported screening for inhibitors prior to switching. Respondents agreed to share their protocols among their peers, although only four were received by the research team.ConclusionsClinical practice in switching between clotting factor products is variable. Some nurses are switching treatments for patients without the supported of a written protocol, whereas others are involved in writing and implementing protocols. Sharing protocols is a first step in helping to establish best practice.

Do nurses have the switch factor?

Clinical Nurse Specialist, Department of Haemostasis

Department of Paediatrics, Division of Oncology and Haematology

The Journal of Haemophilia Practice

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Do nurses have the switch factor?"}

IntroductionSwitching between clotting factor products is becoming increasingly common as product choice increases and financial pressure grows to choose the...

Do nurses have the switch factor?

Article Category: Clinical Practice

Published Online: Nov 19, 2020

Page range: 129 - 135

DOI: https://doi.org/10.17225/jhp00162

Keywords
nurse experience, switching treatment, haemophilia

© 2020 Greta Mulders et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Do nurses have the switch factor?

Article Category: Clinical Practice

Published Online: Nov 19, 2020

Page range: 129 - 135

DOI: https://doi.org/10.17225/jhp00162

Keywordsnurse experience, switching treatment, haemophilia

© 2020 Greta Mulders et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
nurse experience, switching treatment, haemophilia