For many people with leukemia, lymphoma and other diseases, stem cells collected from umbilical cord blood have provided life-saving therapy, yet donations of the blood remain low. In Florida, nurses actively recruit new moms to allow collection of their babies’ cord blood. “It’s about education, because once patients know it’s not hurting them or the baby, they say, why not,” said Denise Vonderstrasse, RN, a labor and delivery nurse at Shands HealthCare in Gainesville, Fla.
Vonderstrasse spearheaded efforts to jump-start collections of cord blood at Shands, which have increased from about five units per year four years ago to five units per day. “It wasn’t easy, for sure,” Vonderstrasse said. She met with an attending physician who helped secure physician support and collaborated with people from LifeCord Cord Blood Bank in Gainesville. Vondertrasse decorated the L&D unit with posters and met with every nurse to provide training about how to collect the blood. She convinced the hospital to add a question to the admission packet, reminding the nurse to ask about cord-blood donation.Denise Vonderstrasse, RN, L&D unit, Shands HealthCare
Kim Zimmerman, RNC-OB, MSN, CNML, director of obstetrical services for South Miami Hospital, finds the majority of the hospital’s patients willing to donate. Education begins with prenatal classes, and the hospital advertises its public-banking capability. CORD:USE Cord Blood Bank of Orlando handles collection postdelivery.
Memorial Healthcare System in Hollywood, Fla., has seen a significant increase in public cord-blood donations, collecting more than 400 units since November 2010. “That has everything to do with the nursing staff,” said Mary Roberts, RN, EdD, director of nursing, maternal services at Memorial Hospital West. “We are successful because of nurse buy-in.”
L&D nurses at Memorial talk with new moms about donations, screen for conditions that may preclude donation and obtain informed consent. The physician collects the blood and turns the unit over to CORD:USE. Donation costs the patient nothing. The blood is banked, and the stem cells are used in transplants to treat patients with leukemia, lymphoma and other cancers. Roberts also reports stem cell use for sickle cell disease and other conditions. “Stem cells from cord blood are the future,” said Roberts, who adds that the majority of bone-marrow transplants use cord blood.
Julie Frain, RN, BS, MBA, CORD:USE RN supervisor at Winnie Palmer Hospital for Women & Babies in Orlando, adds that use of cord-blood stem cells are not controversial among her patients. She finds that moms often know about private banking but often are unaware they can donate to benefit someone else. “It’s a good reward for me as a nurse,” Frain said. “We never know who it will help.”
Traditionally, unless the parents had decided to privately bank their baby’s cord blood, delivery teams threw the umbilical cords out with other medical waste after the birth. “How could somebody not want to save someone’s life with something that normally goes in the trash?” asked Vonderstrasse.Photo courtesy of South Miami Hospital
Seventy percent of people will not find a family member with a human leukocyte antigen match, and the medical team often will turn to donated cord blood.
The Stem Cell Therapeutic and Research Act of 2005 created the National Cord Blood Inventory. It was amended in 2010, setting a goal for the blood inventory to collect and store at least 150,000 high-quality and genetically diverse cord-blood units. The U.S. General Accountability Office reported that as of May 31, the inventory had banked about 41,000 cord-blood units: 41% from nonHispanic Caucasian donors, 30% from Hispanic Caucasian babies, 14% from African-American donors and 4% from Asian babies. “There is a shortage of minority donors,” Frain said. “Increasing the National Cord Blood Inventory will give others the chance to have a match. We are just at the beginning [of using stem cells], and I am proud to be part of it.”
Congress authorized $112 million to fund collections through 2015. The Health Resources and Services Administration’s contracts with the 13 participating cord-blood banks include racial and ethnic group collection goals. •