Winning the Race: A Proactive, Nurse-Managed Treatment Plan for Head and Neck Cancer

2.50
Hdl Handle:
http://hdl.handle.net/10755/165631
Category:
Abstract
Type:
Presentation
Title:
Winning the Race: A Proactive, Nurse-Managed Treatment Plan for Head and Neck Cancer
Author(s):
Costello, Rosemary
Author Details:
Rosemary Costello, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Abstract:
Background: Head and neck cancer is curable in approximately 40% of cases. Aggressive therapy with appropriately selected patients improves these odds, but is accompanied by numerous side effects. In order to achieve the best results, it is important to deliver treatment at full doses, without treatment breaks. Our current curative protocol consists of three cycles of chemotherapy followed by seven weeks of chemoradiation. Program: We have a proactive, nurse-managed treatment program that supports the patient before, during, and after therapy in order to ensure that maximum therapy is delivered and long-term complications are minimized. We accomplish these goals through our RACE approach. We "R"eady the patients by educating them regarding what to expect and how to be active participants in their care. Each patient receives a binder with educational materials detailing chemotherapy, expected side effects, portacath, PEG, radiation, nutrition, and dental information. We also screen each patient for depression and substance abuse. We "A"nticipate side effects and are proactive in partnering with the patient to prevent and handle adverse events. The patients are given computer-generated calendars with detailed instructions for taking prophylactic medicines. Daily phone calls keep us informed of their welfare and enable us to make prompt interventions. Patients are hydrated either at home or in clinic until they are able to maintain adequate po intake. Blood work is checked frequently and growth factors are ordered as necessary. We "C"ollaborate with other disciplines including nutrition, social work, speech, and swallowing experts, dentistry, and psychiatry to support the patient throughout. We continually "E"valuate this program in order to maximize the patient's quality of life after treatment. Long-term side effects include dysphagia, xerostomia, fatigue, and prolonged mucositis. We continue to investigate ways to minimize these sequelae in order to improve patient well being after treatment. Current interests include salivary stimulants and ROM exercises to improve swallowing. Discussion: Of 26 patients who finished treatment, only five were dose-reduced and one had a radiation break. Patients expressed feelings of safety and security with such close management. As access to aggressive therapy becomes more widespread, the oncology nurse role is essential to successful patient outcomes.
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.titleWinning the Race: A Proactive, Nurse-Managed Treatment Plan for Head and Neck Canceren_GB
dc.contributor.authorCostello, Rosemaryen_US
dc.author.detailsRosemary Costello, Dana-Farber Cancer Institute, Boston, Massachusetts, USAen_US
dc.identifier.urihttp://hdl.handle.net/10755/165631-
dc.description.abstractBackground: Head and neck cancer is curable in approximately 40% of cases. Aggressive therapy with appropriately selected patients improves these odds, but is accompanied by numerous side effects. In order to achieve the best results, it is important to deliver treatment at full doses, without treatment breaks. Our current curative protocol consists of three cycles of chemotherapy followed by seven weeks of chemoradiation. Program: We have a proactive, nurse-managed treatment program that supports the patient before, during, and after therapy in order to ensure that maximum therapy is delivered and long-term complications are minimized. We accomplish these goals through our RACE approach. We "R"eady the patients by educating them regarding what to expect and how to be active participants in their care. Each patient receives a binder with educational materials detailing chemotherapy, expected side effects, portacath, PEG, radiation, nutrition, and dental information. We also screen each patient for depression and substance abuse. We "A"nticipate side effects and are proactive in partnering with the patient to prevent and handle adverse events. The patients are given computer-generated calendars with detailed instructions for taking prophylactic medicines. Daily phone calls keep us informed of their welfare and enable us to make prompt interventions. Patients are hydrated either at home or in clinic until they are able to maintain adequate po intake. Blood work is checked frequently and growth factors are ordered as necessary. We "C"ollaborate with other disciplines including nutrition, social work, speech, and swallowing experts, dentistry, and psychiatry to support the patient throughout. We continually "E"valuate this program in order to maximize the patient's quality of life after treatment. Long-term side effects include dysphagia, xerostomia, fatigue, and prolonged mucositis. We continue to investigate ways to minimize these sequelae in order to improve patient well being after treatment. Current interests include salivary stimulants and ROM exercises to improve swallowing. Discussion: Of 26 patients who finished treatment, only five were dose-reduced and one had a radiation break. Patients expressed feelings of safety and security with such close management. As access to aggressive therapy becomes more widespread, the oncology nurse role is essential to successful patient outcomes.en_GB
dc.date.available2011-10-27T12:22:09Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:22:09Z-
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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