ENEMA USE PROHIBITED IN THE NEUTROPENIC AND THROMBOCYTOPENIC PATIENT: WHAT IS THE EVIDENCE?

22.00
Hdl Handle:
http://hdl.handle.net/10755/164877
Category:
Abstract
Type:
Presentation
Title:
ENEMA USE PROHIBITED IN THE NEUTROPENIC AND THROMBOCYTOPENIC PATIENT: WHAT IS THE EVIDENCE?
Author(s):
Sorensen, Elizabeth
Author Details:
Elizabeth Sorensen, MSN APRN BC, Advanced Practice Nurse Fellow, UT MD Anderson Cancer Center, Houston, Texas, USA
Abstract:
Constipation is a common side-effect experienced by many cancer patients that may be related to chemotherapy agents, opioids for pain management, diet change, decreased mobility, or altered bowel habits. Another common side-effect related to cancer and its treatment is bone marrow suppression resulting in neutropenia and thrombocytopenia. Currently, enema and suppository administration is prohibited in patients with neutropenia and/or thrombocytopenia due to the risk of bowel perforation, infection, or uncontrolled rectal bleeding. Although the policy is based on solid rationale, no evidence exists to support it. Furthermore, the nurse and patient are left with few options for constipation management aside from oral route medications, which may be difficult to tolerate because of nausea, vomiting, or NPO status. Also, in the case of possible bowel obstruction or impaction, oral route medications may be less effective and rectal route may be required for treatment of the condition and to prevent perforation. The purpose of this project is to identify and evaluate the evidence supporting the practice of enema prohibition for treatment of constipation in the thrombocytopenic/neutropenic cancer patient and to outline guidelines regarding the approach to treatment in this special population. An extensive search of the online databases CINAHL and PubMed was performed using the following search terms: constipation, chemotherapy, enema, thrombocytopenia, neutropenia, infection, and bowel perforation. Institutional policies and procedures and the Oncology Nursing Society guidelines were reviewed. An evidence summary table was developed that describes populations studied, research designs, outcomes and relevant findings that may be applied to practice. A critical appraisal of the literature revealed that limited data were available on the topic due to lack of research regarding the target population and intervention. The results from this evidence based practice project will be presented with suggestions for further follow- up and investigation into the practice using randomized controlled trials in order to update practice guidelines.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleENEMA USE PROHIBITED IN THE NEUTROPENIC AND THROMBOCYTOPENIC PATIENT: WHAT IS THE EVIDENCE?en_GB
dc.contributor.authorSorensen, Elizabethen_US
dc.author.detailsElizabeth Sorensen, MSN APRN BC, Advanced Practice Nurse Fellow, UT MD Anderson Cancer Center, Houston, Texas, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/164877-
dc.description.abstractConstipation is a common side-effect experienced by many cancer patients that may be related to chemotherapy agents, opioids for pain management, diet change, decreased mobility, or altered bowel habits. Another common side-effect related to cancer and its treatment is bone marrow suppression resulting in neutropenia and thrombocytopenia. Currently, enema and suppository administration is prohibited in patients with neutropenia and/or thrombocytopenia due to the risk of bowel perforation, infection, or uncontrolled rectal bleeding. Although the policy is based on solid rationale, no evidence exists to support it. Furthermore, the nurse and patient are left with few options for constipation management aside from oral route medications, which may be difficult to tolerate because of nausea, vomiting, or NPO status. Also, in the case of possible bowel obstruction or impaction, oral route medications may be less effective and rectal route may be required for treatment of the condition and to prevent perforation. The purpose of this project is to identify and evaluate the evidence supporting the practice of enema prohibition for treatment of constipation in the thrombocytopenic/neutropenic cancer patient and to outline guidelines regarding the approach to treatment in this special population. An extensive search of the online databases CINAHL and PubMed was performed using the following search terms: constipation, chemotherapy, enema, thrombocytopenia, neutropenia, infection, and bowel perforation. Institutional policies and procedures and the Oncology Nursing Society guidelines were reviewed. An evidence summary table was developed that describes populations studied, research designs, outcomes and relevant findings that may be applied to practice. A critical appraisal of the literature revealed that limited data were available on the topic due to lack of research regarding the target population and intervention. The results from this evidence based practice project will be presented with suggestions for further follow- up and investigation into the practice using randomized controlled trials in order to update practice guidelines.en_GB
dc.date.available2011-10-27T12:08:35Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:08:35Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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