The National Hemophilia Foundation’s (NHF) Nursing Working Group has been revising and expanding the Nurses’ Guide to Bleeding Disorders (NGBD). First published in 1995, the guide provides comprehensive information and practical ideas to assist nurses at all levels in caring for patients with bleeding disorders.
Over the last several years, the NGBD has further evolved into a readily accessible online resource, serving as an introduction to nurses new to coagulation and as an information source for more experienced nurses. New chapters, which continue to be added in downloadable PDF format, cover a wide range of topics such as hepatitis, orthopedics, pain, rare bleeding disorders and women with bleeding disorders.
“Inhibitor Development,” written by Christine Guelcher, PNP, provides an overview of inhibitors, antibodies to infused factor product, with particular emphasis on the causes and conditions underlying this complication. These include risk factors associated with factor VIII and IX antibody formation, such as age and genetic mutations. She also discusses treatment implications and clinical approaches to both managing acute bleeds and to controlling an inhibitor. Guelcher concludes by touching on the considerable cost of treating hemophilia patients with inhibitors, emphasizing that improvements in inhibitor care will “hinge on collaboration” within the bleeding disorders community.
