Falls are a contributing factor to increased morbidity in the elderly and chronically ill populations and can affect overall quality of life. The literature indicates that oncology patients are a particularly vulnerable population who are further at risk for falls due to increased age, treatment related fatigue, side effects of medications, co-morbidities, decreased muscle tone, altered mental status, and anemia. Although patients with cancer are at a high risk for falls, this is not a well-documented patient problem in the nursing literature. This study examined the validity of the use of the Morse Fall Assessment Tool for use with Bone Marrow Transplant patients and explored other variables that might influence fall outcomes. This study was a retrospective chart review. The sample consisted of a total of 59 patients, which included 29 fallers and 30 non-fallers on a bone marrow transplant unit. There were 22 males and 37 females, ranging in age from 20 to 70 with a mean age of 53.9 (SD= 12.2).The results of this study indicate that there is a significant difference between fallers' (M= 43.8) and non-fallers' (M= 26.8) scores on the Morse Fall Scale (p= 0.000). Significant differences between groups were found with history of falls (p= 0.042), secondary diagnosis (p= 0.015), and muscle weakness (p= 0.025). Laboratory results from fallers and non-fallers revealed significant differences in platelet count (p= 0.003), BUN (p= 0.032), glucose (p= 0.009), and phosphorous (p= 0.001). This is the first study to document falls in the bone marrow transplant population. This study should be a stimulus for future studies conducted in the oncology and/or bone marrow transplant population. Studying falls in these patients is essential to understanding the physiological risk factors that may contribute to patient falls. Findings lay the foundation for studying falls in the bone marrow transplant population. It is crucial to study falls in this population in order to make appropriate assessments and interventions to keep this population free from injury.

In oncology setting, there is a range of emotions felt by patients and nurses alike such as helplessness, anger, sadness and anxiety; and this is especially the case as patients near the end of life. The literature shows there is an interest in nurses' attitudes toward caring for patients who are near the end of life. This project examines the overall attitude of Bone Marrow Transplant (BMT) nurses' attitudes toward caring for patients who are near the end of life using the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD) and a Demographic Data Sheet. This project investigated the demographic variables including age, gender, ethnicity, religion, Oncology Certified Nurses status, highest degree held, years of nursing experience, years of oncology experience, years of BMT experience, prior continuing education in end of life, and prior experience taking care of a terminally ill patient, to see if they contribute to these differences in attitudes. This was a descriptive project. The sample consisted of a total of 30 BMT nurses, which included 8 men, and 22 women who have worked on the BMT unit for over a year. The mean years of nursing experience was 13.9 (SD=10.10), mean years of oncology nursing experience was 8 (SD=5.80), and mean years of BMT experience was 7.2 (SD=.60). The results of this project indicate that there is a positive relationship between number of years of experience as a nurse and positive attitudes toward caring for patients who are near the end of life. Scores on the FATCOD had a possibility to range from 30-150, with higher scores indicating a more positive attitude toward care of the dying. The scores from this project ranged from 113-148 with a mean of 128.6, indicating an overall positive attitude toward caring for the dying. This project should spur further investigation into attitudes toward caring for patients who are near the end of life. Nurses strive to take the best possible care of their patients and having an understanding of their attitudes will help them recognize areas of strength and weakness. This project supports interventions that are already being done by End of Life (EOL) Committee on the BMT unit at the Moffitt Cancer Center. The EOL committee is helping to create positive attitudes about caring for patients who are near the end of life by both supportive and educational methods.