Nurse Driven Neutropenia Management Guidelines: Improving Patient Outcomes Through Evidence-Based Practice

2.50
Hdl Handle:
http://hdl.handle.net/10755/165583
Category:
Abstract
Type:
Presentation
Title:
Nurse Driven Neutropenia Management Guidelines: Improving Patient Outcomes Through Evidence-Based Practice
Author(s):
Maxwell, Cathy
Author Details:
Cathy Maxwell, Oncology Hematology Group of South Florida, Miami, Florida, USA
Abstract:
In early 1998 our community oncology practice participated in a large physician practice pattern data collection. This retrospective chart review collected data on breast cancer patients receiving adjuvant chemotherapy. According to a study by Bonadonna (NEJM, 1995), breast cancer patients receiving less than 85% of their planned total chemotherapy dose had a lower percentage of relapse-free and overall survival. We used 85% as a dose intensity benchmark to determine how well our 10 physician practice was at delivering chemotherapy as planned. Our data showed that 38% of the patients studied experienced dose reductions and 42% experienced dose delays. Overall, 24% of the patients received less than 85% of their planned dose intensity and 3% were hospitalized due to a febrile neutropenic event. It was evident that many of the dose reductions and delays were due to neutropenia and that each physician's results varied depending on how neutropenia was managed. The physicians and key nurses in the practice met to discuss ways to improve the quality of care being delivered to breast cancer patients. A team of nurses and physicians developed guidelines for neutropenia management that included intervention with Filgrastim treatment for breast cancer patients identified as being at risk for dose reductions and dose delays due to neutropenia. The guidelines were implemented in October 1998. In September of 2000 we again conducted a chart review of our breast cancer patients. The results were improved. Twenty percent of the patients experienced dose reductions and 35% experienced dose delays. Only 5% of the patients received less than 85% of their planned dose intensity and there were no patients hospitalized for febrile neutropenia. The patients of all 10 physicians were now being treated in a consistent manner. The key to the success of our guidelines is the nursing staff's responsibility and autonomy in managing patients who become neutropenic. Utilizing guidelines for neutropenia management saves the nursing staff considerable time and has improved the overall flow of patient care for the practice.
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.titleNurse Driven Neutropenia Management Guidelines: Improving Patient Outcomes Through Evidence-Based Practiceen_GB
dc.contributor.authorMaxwell, Cathyen_US
dc.author.detailsCathy Maxwell, Oncology Hematology Group of South Florida, Miami, Florida, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165583-
dc.description.abstractIn early 1998 our community oncology practice participated in a large physician practice pattern data collection. This retrospective chart review collected data on breast cancer patients receiving adjuvant chemotherapy. According to a study by Bonadonna (NEJM, 1995), breast cancer patients receiving less than 85% of their planned total chemotherapy dose had a lower percentage of relapse-free and overall survival. We used 85% as a dose intensity benchmark to determine how well our 10 physician practice was at delivering chemotherapy as planned. Our data showed that 38% of the patients studied experienced dose reductions and 42% experienced dose delays. Overall, 24% of the patients received less than 85% of their planned dose intensity and 3% were hospitalized due to a febrile neutropenic event. It was evident that many of the dose reductions and delays were due to neutropenia and that each physician's results varied depending on how neutropenia was managed. The physicians and key nurses in the practice met to discuss ways to improve the quality of care being delivered to breast cancer patients. A team of nurses and physicians developed guidelines for neutropenia management that included intervention with Filgrastim treatment for breast cancer patients identified as being at risk for dose reductions and dose delays due to neutropenia. The guidelines were implemented in October 1998. In September of 2000 we again conducted a chart review of our breast cancer patients. The results were improved. Twenty percent of the patients experienced dose reductions and 35% experienced dose delays. Only 5% of the patients received less than 85% of their planned dose intensity and there were no patients hospitalized for febrile neutropenia. The patients of all 10 physicians were now being treated in a consistent manner. The key to the success of our guidelines is the nursing staff's responsibility and autonomy in managing patients who become neutropenic. Utilizing guidelines for neutropenia management saves the nursing staff considerable time and has improved the overall flow of patient care for the practice.en_GB
dc.date.available2011-10-27T12:21:17Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:21:17Z-
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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