NURSING OPPORTUNITIES FOR IMPROVING PREVENTION OF CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING (CINV) THROUGH EVIDENCE-BASED PROPHYLAXIS: EVALUATION OF PROVIDER PERCEPTIONS AND PARTICIPANT OUTCOMES

2.50
Hdl Handle:
http://hdl.handle.net/10755/165098
Category:
Abstract
Type:
Presentation
Title:
NURSING OPPORTUNITIES FOR IMPROVING PREVENTION OF CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING (CINV) THROUGH EVIDENCE-BASED PROPHYLAXIS: EVALUATION OF PROVIDER PERCEPTIONS AND PARTICIPANT OUTCOMES
Author(s):
Purl, Sandra; Stark, J. J.; Ketterl, Petra; Claussen, Amber
Author Details:
Sandra Purl, RN MS AOCN, Oncology Clinical Nurse Specialist, Oncology Specialists, S.C, Park Ridge, Illinois, USA, email: spurl@oncmed.net; J.J. Stark, BS, CRC; Petra Ketterl, MD, Cancer Treatment Centers of America, Tulsa, Oklahoma; Amber Claussen, RN, OCN, Hematology Medical Oncology Consultants, Davenport, Iowa
Abstract:
Despite effective treatment options for CINV and the publication of evidence-based practice (EBP) antiemetic guidelines, CINV continues to negatively impact the lives of patients undergoing moderately emetogenic chemotherapy (MEC). Research indicates that prevention of CINV in the first chemotherapy cycle significantly reduces the risk of CINV in future cycles. Nurses have the opportunity to improve patient outcomes through better understanding and use of EBP options for prevention and treatment of CINV. Purpose: to assess antiemetic practice patterns and identify nursing opportunities for improving antiemetic care and outcomes. Between October 2005 and July 2006 oncologists and oncology nurses completed surveys to document antiemetic regimens prescribed with common MEC treatments, and estimated incidence rates of acute and delayed CINV. Nurses recorded emetic risk factors, cancer diagnosis, chemotherapy and prescribed antiemetics for each participant. Participants completed daily diaries for five days post-treatment to record episodes of nausea and/or vomiting, use of antiemetic rescue medication, functional impact and calls or visits to the provider/ practice due to CINV. Although almost 80% of participants received guideline-based prophylaxis (5-HT3 + dexamethasone ¦ other), there was significant variability in the approach to antiemetic treatment combinations, including antiemetic care inconsistent with EBP. The actual incidence rates of nausea and vomiting were notably higher than the rates estimated by both oncologists and nurses, particularly delayed nausea. Although 65% of participants experienced no emesis without using rescue antiemetics, 60% experienced nausea, and 33% reported functional interference due to nausea. Of the 16% of participants who missed work or a social commitment for poorly controlled nausea or vomiting, just one-fourth called or visited their practice to seek help. Understanding and use of EBP prior to chemotherapy and throughout the delayed period, as well as teaching patients about options to alleviate CINV, remain educational opportunities for oncology nurses. The small number of patients who called or returned to their practice for poorly controlled CINV compared to the number who experienced significant delayed nausea suggests a possible need for creative approaches for patient follow-up beyond the acute period to improve patient outcomes and quality of life.
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.titleNURSING OPPORTUNITIES FOR IMPROVING PREVENTION OF CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING (CINV) THROUGH EVIDENCE-BASED PROPHYLAXIS: EVALUATION OF PROVIDER PERCEPTIONS AND PARTICIPANT OUTCOMESen_GB
dc.contributor.authorPurl, Sandraen_US
dc.contributor.authorStark, J. J.en_US
dc.contributor.authorKetterl, Petraen_US
dc.contributor.authorClaussen, Amberen_US
dc.author.detailsSandra Purl, RN MS AOCN, Oncology Clinical Nurse Specialist, Oncology Specialists, S.C, Park Ridge, Illinois, USA, email: spurl@oncmed.net; J.J. Stark, BS, CRC; Petra Ketterl, MD, Cancer Treatment Centers of America, Tulsa, Oklahoma; Amber Claussen, RN, OCN, Hematology Medical Oncology Consultants, Davenport, Iowaen_US
dc.identifier.urihttp://hdl.handle.net/10755/165098-
dc.description.abstractDespite effective treatment options for CINV and the publication of evidence-based practice (EBP) antiemetic guidelines, CINV continues to negatively impact the lives of patients undergoing moderately emetogenic chemotherapy (MEC). Research indicates that prevention of CINV in the first chemotherapy cycle significantly reduces the risk of CINV in future cycles. Nurses have the opportunity to improve patient outcomes through better understanding and use of EBP options for prevention and treatment of CINV. Purpose: to assess antiemetic practice patterns and identify nursing opportunities for improving antiemetic care and outcomes. Between October 2005 and July 2006 oncologists and oncology nurses completed surveys to document antiemetic regimens prescribed with common MEC treatments, and estimated incidence rates of acute and delayed CINV. Nurses recorded emetic risk factors, cancer diagnosis, chemotherapy and prescribed antiemetics for each participant. Participants completed daily diaries for five days post-treatment to record episodes of nausea and/or vomiting, use of antiemetic rescue medication, functional impact and calls or visits to the provider/ practice due to CINV. Although almost 80% of participants received guideline-based prophylaxis (5-HT3 + dexamethasone ¦ other), there was significant variability in the approach to antiemetic treatment combinations, including antiemetic care inconsistent with EBP. The actual incidence rates of nausea and vomiting were notably higher than the rates estimated by both oncologists and nurses, particularly delayed nausea. Although 65% of participants experienced no emesis without using rescue antiemetics, 60% experienced nausea, and 33% reported functional interference due to nausea. Of the 16% of participants who missed work or a social commitment for poorly controlled nausea or vomiting, just one-fourth called or visited their practice to seek help. Understanding and use of EBP prior to chemotherapy and throughout the delayed period, as well as teaching patients about options to alleviate CINV, remain educational opportunities for oncology nurses. The small number of patients who called or returned to their practice for poorly controlled CINV compared to the number who experienced significant delayed nausea suggests a possible need for creative approaches for patient follow-up beyond the acute period to improve patient outcomes and quality of life.en_GB
dc.date.available2011-10-27T12:12:29Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:12:29Z-
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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