Canadian Oncology Nursing Journal最新文献

This paper reports on a quality improvement project that was conducted collaboratively by an oncology clinical nurse coordinator and simulation nurse educator. The project utilized simulation- based tutorials with a stepwise approach to train and evaluate the self-efficacy of oncology registered nurses working in a tertiary care hospital. A general assessment of the problem of cytotoxic extravasation was explored using an Ishikawa diagram and the factors responsible for such common issues in chemotherapy administration and oncology nursing practice were plotted. The Plan- Do-Study-Act (PDSA) approach was utilized to apply the quality improvement project method and to strategize the learning for the oncology nurses. The simulation tutorials approach used was an innovative educational activity. The project was completed by training each oncology registered nurse to enhance their efficacy in identifying and managing extravasation. The innovation of simulation-based education tutorials was effective in enhancing nurses' practices. It also provided insight for continuous nursing education and evaluation that will impact the clinical practice routines in oncology care, thus saving patients from potential adverse effects of chemotherapy.

Introduction: Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a significant side effect that profoundly affects patients' quality of life (QOL). Nurses play a critical role to enhance CIPN care through assessments, patient education and symptom management This study aimed to evaluate the effectiveness of an educational program on CIPN in improving the competency of nurses in managing CIPN at Kenyatta National Hospital (KNH) in Kenya.

Methodology: Ethical approvals were obtained from the institutions' ethics and research committees. A pretest-posttest quasi-experimental design was utilized, involving 43 nurses at the Cancer Treatment Centre (CTC). Structured self-administered questionnaires were used for data collection in April 2023 (baseline) to February 2024 (6-month follow-up). A two-day training program was conducted in July/August 2023. Descriptive statistics and paired sample t-test were used for analysis. These findings yielded a comparison of an overall competency score with p < 0.005 as significant.

Results: There were 43 participants, of which 67.4% were females, 62.8% held diplomas in nursing, 27.9% had a Bachelor of Science in Nursing (BScN) degree. More than half (58.1%) had 5 years or less of oncology experience, and 83.7% lacked formal oncology training. Awareness of risk factors for CIPN significantly improved after the educational program, with knowledge of older patient age rising from 67.4% to 97.4% (P = 0.0005) and recognition of a history of smoking increasing from 60.5% to 92.3% (P = 0.0003). Knowledge of specific chemotherapy agents associated with CIPN surged from 16.3% to 56.4% (P = 0.0006). For knowledge about symptoms, muscle weakness awareness improved from 62.8% to 94.9% (P = 0.0008). Regarding treatment awareness, knowledge of duloxetine's effectiveness increased from 60.5% to 100% (P = 0.0001). For nurses' practices, responses for screening at baseline of "Never" decreased from 9.3% to 0%, and "Frequently" increased from 4.7% to 69.2%. Overall, the mean score for frequency of CIPN screening rose from 4.1 (standard deviation [SD] = 2.0) to 6.8 (SD = 1.4) (P = 0.0000). Both the overall CIPN knowledge score (p < 0 .0001) and practice scores (p < 0.0001) increased significantly. The overall competency score rose from a mean of 32.5 (SD = 7.8) to 46.1 (SD = 5.6) (p < 0.0001).

Conclusion and recommendation: CIPN education program was effective in improving competencies of nurses. There is need to establish a continuous medical education program on CIPN and chemotherapy effects and staff mentorship for better care. Additionally, the CIPN training needs to be integrated into the Ministry of Health's educational program.

Background: The number of paclitaxel infusion reactions was observed as the highest among all Cancer Medication Infusion Reactions (CMIR) in the Cancer Care and Hematology Clinic at Scarborough Health Network (SHN) despite the use of pre-medication. This quality improvement project was aimed at reducing the number of paclitaxel reactions and reducing extended chair time due to infusion reactions.

Method: Our quality improvement strategy focused on monitoring paclitaxel reaction rates while using a standardized titration rate strategy for patients receiving the first three lifetime cycles of paclitaxel infusion for solid tumours or hematologic malignancies. The titration rate was calculated with a variety of drug volumes that are used within the Scarborough Health Network. Findings from the 4 months of piloting the titration rate strategy were compared to the previous 4 months when titration rates were not used.

Result: Four months after introducing the new strategy, there were 35.71% paclitaxel reactions when a titration rate was used as compared to 51.35% reactions when a titration rate was not used. Patients who received paclitaxel infusion using titration rates increased the scheduled chair time to 30 minutes to allow for slower infusion rates, while patients with hypersensitivity reactions (HSRs) required an extra 3 hours of chair time that was not pre-planned.

Conclusion: There were fewer HSRs after the launch of the titration rate strategy in patients receiving paclitaxel for the first three lifetime cycles. This strategy also reduced overall chair time at the clinic.

This study aimed to 1) describe adolescent cancer survivors' transition readiness and self-reported goals in a limited clinical sample; and 2) investigate healthcare providers' (HCPs') perspectives about a nurse-led clinical utilization of the Transition Readiness Assessment Questionnaire (TRAQ) and its subsequent discontinuation in a long-term follow-up (LTFU) pediatric oncology clinic. Data were collected from adolescent survivors (n = 7) at a tertiary pediatric hospital, while in-depth interviews were conducted with HCPs (n = 3) from the LTFU oncology clinic. Qualitative data revealed barriers, facilitators, and strategies for TRAQ implementation, relating to the tool, HCPs, adolescents, and the clinical context. The understanding of the barriers and facilitators to TRAQ use will support a structured implementation plan for TRAQ use in future clinical practice. Analysis revealed varying levels of readiness for transition to adult care services among patients and identified themes in their self-set goals, supporting the need for transition readiness supports in this population.

Recent advancements in oncology have significantly transformed cancer treatment and care management, offering new hope to patients worldwide. This literature review examines key therapeutic breakthroughs, including targeted therapies, immunotherapies, personalized medicine, and innovative drug delivery systems. These cutting-edge interventions have enhanced patient outcomes, improving survival rates and quality of life, but they have also introduced complexities in managing emerging side effects, care coordination, and resource allocation. This review discusses the implications of these therapies on patient care, the ethical considerations they entail, the management of side effects, and the pivotal role of oncology nurses in administering and managing these treatments. By exploring the current landscape and future directions of oncology therapies, including areas such as cancer vaccines and precision medicine, this article provides a comprehensive understanding of how these innovations are shaping the future of cancer care.

Emerging trends in oncology nursing literature indicate an increasing need for specialized roles. The increasing complexity of cancer care presents a unique opportunity to expand the cancer patient navigator role to population cancer screening programs. Existing oncology nurse navigation competencies can be leveraged to improve cancer screening participation and reduce waiting times for access to diagnostic and treatment pathways. By expanding the scope of practice for oncology nurse navigators to include roles such as community engagement and improved access to care, nurse navigators in cancer screening programs can play a pivotal role in reducing cancer burden and improve health outcomes at a population level. In 2019, Newfoundland and Labrador's (NL) Provincial Cancer Care Program introduced a Screening Navigator position within its Population Screening Programs and specified community engagement and outreach as key requirements within the role. In 2021, a second screening navigator position was added. This article will highlight the expanded responsibilities of oncology nurse navigators in NL's Population Screening Program to facilitate improved participant access, continuity of screening and diagnostic pathways and community engagement. By expanding the navigator scope to include cancer screening, community engagement, and improved access to care, oncology nurse navigators play a key role in reducing cancer burden and improve health outcomes at a population level.

In recent years, oncology has witnessed significant advancements in prevention strategies and early detection technologies, profoundly impacting patient outcomes. This literature review aims to equip oncology nurses, particularly those new to the field, with a comprehensive understanding of these developments. The review delves into the implementation of vaccines, lifestyle modifications, and cutting-edge screening technologies, highlighting the role of genetic and genomic screening in identifying cancer susceptibility, accompanied by ethical considerations. Furthermore, the review critically examines the contributions of oncology nursing in promoting these preventive measures and underscores the importance of public health policies in fostering their adoption. By focusing on these advancements, the review provides a detailed analysis of the current landscape and future prospects in oncology prevention and early detection, emphasizing their significance in enhancing patient care and survival rates.

Many patients with otolaryngological (ENT) cancers are treated with various combinations of surgery, radiation therapy and chemotherapy. Acute toxicity from radiation therapy can be experienced during and after treatment. Managing toxicity can be a complex process, often requiring the involvement of a multidisciplinary team. Early detection and management of treatment-related toxicity can improve short- and long-term outcomes for patients. Nurses, being at the heart of patient care, are in the best position to detect and treat acute toxicity. This paper explores a systematic nurse-led approach to monitoring acute toxicity. This approach was developed and implemented by a clinical oncology nurse in a university-affiliated cancer care centre to facilitate the early detection and management of symptoms in these patients.