Oral Mucositis Assessment for Pediatric and Adult Ambulatory Care and Inpatients: An Evidence-Based Approach

2.50
Hdl Handle:
http://hdl.handle.net/10755/159741
Type:
Presentation
Title:
Oral Mucositis Assessment for Pediatric and Adult Ambulatory Care and Inpatients: An Evidence-Based Approach
Abstract:
Oral Mucositis Assessment for Pediatric and Adult Ambulatory Care and Inpatients: An Evidence-Based Approach
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Cullen, Laura, MA, RN
P.I. Institution Name:University of Iowa Hospitals and Clinics
Contact Address:200 Hawkins Dr., Iowa City, IA, 52242, USA
Contact Telephone:319-384-9144
Co-Authors:L. Cullen, Nursing Research, Quality and Outcomes Management, University of Iowa Hospitals and Clinics, Iowa City, IA;
The program goal is for evidence-based prevention and treatment of oral mucositis for all oncology patients seen in our organization. The first step is implementation of an evidence-based oral assessment for adult and pediatric patients. Oral mucositis is a frequent side effect of cancer therapy (Avritscher et al., 2006; Brown et al., 2004; Dodd, 2004; Epstein, 2004; Fulton et al., 2002) and leads to delayed treatment, reduced treatment dosage, altered nutrition, dehydration, infections, xerostomia, pain and higher costs (Brown et al., 2004; Sonis et al., 2004) and is the most distressing side effect (Jaroneski, 2006). And 67% of oncology nurses are unaware of available guidelines (McGuire et al., 2005). Use of an evidence-based oral health assessment is the first step in a comprehensive program for prevention and treatment (Jaroneski, 2006). The Oral Assessment Guide (OAG) has good reliability, validity, feasibility and sensitivity and was chosen for use (Eilers, 2004). The OAG was piloted on Adult Leukemia and Bone Marrow Transplant (ALBMT) in 9/06. Feedback led to adapting the OAG for use. Pilot evaluation (8/23 or 35% response) showed staff can identify at risk patients (3.3, 1-4 scale) and identify mucosal changes (2.9, 1-4 scale). Only 8 patients were diagnosed with oral mucositis by hospital billing, ICD-9 code 528.01-oral mucositis, from 10/06 through 7/07, which will be followed. Hospital-wide roll out occurred in 10/07. Nursing assessment was evaluated in 7/08 and is documented 87% of the time, and 99% for inpatients. Pediatric and adult BMT patients have the worst mucositis on day 10. Head and neck radiation patients are at highest risk (Avritscher et.al., 2004; Brown et al., 2004) and 88% of audited visits had documentation. Other clinics require further work on documentation. Use of an evidence-based assessment is the first step in a comprehensive program to reduce a common and highly distressing side effect of cancer treatment. Nursing documentation of oral assessment is well integrated into practice for inpatients. Opportunities for improvement remain in ambulatory care. Multidisciplinary team collaborations to expand evidence-based prevention and treatment and research questions generated from this work will be shared.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleOral Mucositis Assessment for Pediatric and Adult Ambulatory Care and Inpatients: An Evidence-Based Approachen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159741-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Oral Mucositis Assessment for Pediatric and Adult Ambulatory Care and Inpatients: An Evidence-Based Approach</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cullen, Laura, MA, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Iowa Hospitals and Clinics</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">200 Hawkins Dr., Iowa City, IA, 52242, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">319-384-9144</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">laura-cullen@uiowa.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">L. Cullen, Nursing Research, Quality and Outcomes Management, University of Iowa Hospitals and Clinics, Iowa City, IA;</td></tr><tr><td colspan="2" class="item-abstract">The program goal is for evidence-based prevention and treatment of oral mucositis for all oncology patients seen in our organization. The first step is implementation of an evidence-based oral assessment for adult and pediatric patients. Oral mucositis is a frequent side effect of cancer therapy (Avritscher et al., 2006; Brown et al., 2004; Dodd, 2004; Epstein, 2004; Fulton et al., 2002) and leads to delayed treatment, reduced treatment dosage, altered nutrition, dehydration, infections, xerostomia, pain and higher costs (Brown et al., 2004; Sonis et al., 2004) and is the most distressing side effect (Jaroneski, 2006). And 67% of oncology nurses are unaware of available guidelines (McGuire et al., 2005). Use of an evidence-based oral health assessment is the first step in a comprehensive program for prevention and treatment (Jaroneski, 2006). The Oral Assessment Guide (OAG) has good reliability, validity, feasibility and sensitivity and was chosen for use (Eilers, 2004). The OAG was piloted on Adult Leukemia and Bone Marrow Transplant (ALBMT) in 9/06. Feedback led to adapting the OAG for use. Pilot evaluation (8/23 or 35% response) showed staff can identify at risk patients (3.3, 1-4 scale) and identify mucosal changes (2.9, 1-4 scale). Only 8 patients were diagnosed with oral mucositis by hospital billing, ICD-9 code 528.01-oral mucositis, from 10/06 through 7/07, which will be followed. Hospital-wide roll out occurred in 10/07. Nursing assessment was evaluated in 7/08 and is documented 87% of the time, and 99% for inpatients. Pediatric and adult BMT patients have the worst mucositis on day 10. Head and neck radiation patients are at highest risk (Avritscher et.al., 2004; Brown et al., 2004) and 88% of audited visits had documentation. Other clinics require further work on documentation. Use of an evidence-based assessment is the first step in a comprehensive program to reduce a common and highly distressing side effect of cancer treatment. Nursing documentation of oral assessment is well integrated into practice for inpatients. Opportunities for improvement remain in ambulatory care. Multidisciplinary team collaborations to expand evidence-based prevention and treatment and research questions generated from this work will be shared.</td></tr></table>en_GB
dc.date.available2011-10-26T22:17:30Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:17:30Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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