Clinical Guidelines for Use of Erythropoietin in Cancer Patients: A Nursing Perspective on Barriers and Benefits

2.50
Hdl Handle:
http://hdl.handle.net/10755/165580
Category:
Abstract
Type:
Presentation
Title:
Clinical Guidelines for Use of Erythropoietin in Cancer Patients: A Nursing Perspective on Barriers and Benefits
Author(s):
Ross, Susan
Author Details:
Susan Ross, MetaWorks Inc., Medford, Massachusetts, USA
Abstract:
Objective: Our objective is to promote nursing implementation of a guideline for anemia treatment in cancer patients. Outpatient oncology practice is heavily dependent upon nurses as both patient advocates and front-line care providers. Success of guidelines in this setting depends on identifying and addressing issues unique to nurses. Method: A panel of four oncology nurses from disparate practice settings convened to review an evidence-based guideline for the treatment of chemotherapy-related anemia. The guideline focused on the use of erythropoietin (EPO), was developed by a multidisciplinary panel, and was based on a systematic review of the literature through August 2000. Aspects of guideline implementation of concern to oncology nurses were discussed. Results: The panel listed barriers to and benefits of implementation of the guideline in oncology nursing settings. The barriers were: 1) variable reimbursement rules, especially regarding location of anemia treatment administration (office versus hospital), and excessive time required by nurses to pre-certify payment for EPO; 2) patient inconvenience and drain on productivity to adhere to guideline regarding frequency of injections; 3) variable physician attitudes toward recognizing and treating symptoms of anemia, and toward "soft" measures of efficacy such as cognitive function and quality of life; 4) institutional failure to assess all costs associated with anemia; and 5) regional differences in practice patterns and infrastructure. The benefits were: 1) improved patient care-reduction in error, variation, and inappropriate care with enhanced continuity of care; 2) support of CQI activities; 3) medicolegal protection; 4) control of transfusion-associated costs (direct and indirect); 5) support of patient advocacy efforts; 6) improved work flow; 7) educational value regarding anemia and proper EPO dosing; 8) improved adherence to chemotherapy schedules; 9) identification of evidence gaps susceptible to new research; and 10) improved assessment of etiology of anemia. Conclusion: The successful implementation of guidelines for anemia treatment will depend on reinforcing the many ways the guideline can benefit both patients and nurses and recognizing and removing the barriers. The knowledgeable support of nurses, in addition to scientific advances such as the development of a new generation of erythroiesis stimulating proteins to overcome dosing inconvenience barriers, may facilitate guideline acceptance.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., 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.titleClinical Guidelines for Use of Erythropoietin in Cancer Patients: A Nursing Perspective on Barriers and Benefitsen_GB
dc.contributor.authorRoss, Susanen_US
dc.author.detailsSusan Ross, MetaWorks Inc., Medford, Massachusetts, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165580-
dc.description.abstractObjective: Our objective is to promote nursing implementation of a guideline for anemia treatment in cancer patients. Outpatient oncology practice is heavily dependent upon nurses as both patient advocates and front-line care providers. Success of guidelines in this setting depends on identifying and addressing issues unique to nurses. Method: A panel of four oncology nurses from disparate practice settings convened to review an evidence-based guideline for the treatment of chemotherapy-related anemia. The guideline focused on the use of erythropoietin (EPO), was developed by a multidisciplinary panel, and was based on a systematic review of the literature through August 2000. Aspects of guideline implementation of concern to oncology nurses were discussed. Results: The panel listed barriers to and benefits of implementation of the guideline in oncology nursing settings. The barriers were: 1) variable reimbursement rules, especially regarding location of anemia treatment administration (office versus hospital), and excessive time required by nurses to pre-certify payment for EPO; 2) patient inconvenience and drain on productivity to adhere to guideline regarding frequency of injections; 3) variable physician attitudes toward recognizing and treating symptoms of anemia, and toward "soft" measures of efficacy such as cognitive function and quality of life; 4) institutional failure to assess all costs associated with anemia; and 5) regional differences in practice patterns and infrastructure. The benefits were: 1) improved patient care-reduction in error, variation, and inappropriate care with enhanced continuity of care; 2) support of CQI activities; 3) medicolegal protection; 4) control of transfusion-associated costs (direct and indirect); 5) support of patient advocacy efforts; 6) improved work flow; 7) educational value regarding anemia and proper EPO dosing; 8) improved adherence to chemotherapy schedules; 9) identification of evidence gaps susceptible to new research; and 10) improved assessment of etiology of anemia. Conclusion: The successful implementation of guidelines for anemia treatment will depend on reinforcing the many ways the guideline can benefit both patients and nurses and recognizing and removing the barriers. The knowledgeable support of nurses, in addition to scientific advances such as the development of a new generation of erythroiesis stimulating proteins to overcome dosing inconvenience barriers, may facilitate guideline acceptance.en_GB
dc.date.available2011-10-27T12:21:14Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:21:14Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., 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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