From peer and patient education to addressing treatment side effects and other patient care needs, nurses at Rutgers Cancer Institute of New Jersey researched a number of topics with an aim of enhancing the patient experience. Findings from their work are being presented as part of a poster session at the Oncology Nursing Society's Annual Congress being held this week in Washington, D.C.
Side effects from cancer treatment are something oncology nurses need to be well-informed of as they usually are the ones to teach patients about what they can expect and how to manage those complications. Dorothy N. Pierce, DNP, NP-C, CRN, CBCN, CLT, an advanced practice nurse in radiation oncology at Rutgers Cancer Institute examined best practices for preventing a condition known as vaginal stenosis. This abnormal tightening and shortening of the vagina can be caused by pelvic radiation therapy and/or brachytherapy treatment for uterine, cervical and vaginal cancers.
A small sample size from six New Jersey counties consisting of advanced practice nurses, registered nurses and a brachytherapy therapist from radiation oncology programs were surveyed via phone about whether their patients were counseled on various aspects associated with the prevention of vaginal stenosis. Survey results showed inconsistent practices with the dissemination of this information, and advanced practice nurses were underutilized in this delivery.
"While not life threatening, vaginal stenosis can affect the physical and psychological well-being, social functioning and quality of life of patients who develop the condition as a result of pelvic radiation treatment," notes Dr. Pierce. "Advanced practice nurses are on the front lines in helping these patients manage this side effect. This survey shows that inconsistencies in the information given to patients and how it is given are items that need to be addressed." Pierce notes that any future study on this topic should include a larger sample size.
Rutgers Cancer Institute nurses also examined two patient-centered care approaches to palliative care and found a need to align these approaches. Investigators note such standardization could help clinical providers increase guideline-based interventions as well as educate families about the benefits of palliative care services.
Spiritual well-being also was explored by Rutgers Cancer Institute nurses, as they identified a need to improve assessment and documentation with patients. Nurses implemented a mandatory online education course on the topic with an aim of teaching healthcare team members how to better address and assess spiritual needs. An evaluation of the course showed an increased level of comfort and knowledge of this subject. Nurses implemented an existing pocket card tool for assessment and modified electronic nursing documents to better capture spirituality assessment. Investigators say that use of a combination of these tools can be adapted by all nurses nationally to help improve patient outcomes.
A reinstitution of a nursing preceptor course was developed and examined, and enhancement of nursing recruitment and retention through expansion of interviewing, mentoring and onboarding/orientation procedures also were explored.
"Oncology nurses are at the forefront of providing quality care to meet patient and family needs ranging from physical, psychosocial and spiritual. They are dedicated to not only being fully educated on practice guidelines but also to improving and implementing them. The comprehensive projects our nurses conduct in all of these areas is vital to clinical practice and helping patients have the best outcomes possible," notes Rutgers Cancer Institute Chief Nursing Officer Janet Gordils-Perez, DNP, RN, ANP-BC, AOCNP.