Medicine and Health Sciences Commons^™

A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse

Walden Dissertations and Doctoral Studies

Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool …

A Multidisciplinary Approach To Managing Financial Toxicity In Oncology Patients, Katelin Muse

Walden Dissertations and Doctoral Studies

Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool …

Unleashing Wellness: Exploring The Impact Of Pet Therapy On Anxiety Reduction, Quality Of Life, And Treatment Adherence In Pediatric Oncology Patients, Karina Brouwer

Nursing | Student Research Posters

Pet therapy is a complementary type of therapeutics in which a person and animal have a guided interaction with the purpose of helping someone cope with physical and/or mental illness. Animal-assisted therapy is used in numerous settings and has been shown to reduce stress, lower blood pressure and heart rate, and decrease anxiety and depression (Husson University, 2022). In particular, pediatric oncology patients have enormous amounts of stress in their lives, which leads to increased anxiety and decreased quality of life (Children's Cancer Cause, 2023). While evidence shows that integrating pet therapy in pediatric oncology patients produces significant benefits on …

Unleashing Wellness: Exploring The Impact Of Pet Therapy On Anxiety Reduction, Quality Of Life, And Treatment Adherence In Pediatric Oncology Patients, Karina Brouwer

Nursing | Senior Theses

Pet therapy is a complementary intervention that involves the interaction between a person and animal, with the focus of improving psychological well-being within diverse populations. In particular, children with oncological disorders have increases in anxiety and stress levels, therefore it is imperative to study the impact of animal interventions within this population. This literature critique explores the impact of pet therapy interventions on anxiety, stress, and quality of life perceptions in pediatric oncology patients. This research proposal will investigate how animal therapy interactions within pediatric oncology patients influence their anxiety levels and perceptions of quality of life and how these …

Evaluating A Novel Patient Intake Model For Newly Referred Patients Seeking Cancer Care: An Evidence-Based Practice Project, Roquinna Serna, Stella Fernandez, Morgan Nestingen, Stephen Breazeale

Nursing & Health Sciences Research Journal

Introduction: Cancer survivors must engage in a complex medical system that requires coordinating care, traveling for treatment, obtaining referrals, and scheduling multiple appointments with various teams. Cancer care facilities are implementing oncology navigation programs that help survivors navigate barriers in complex cancer care systems. However, new patients require additional support prior to their first visit. This article aims to describe the development and design of Miami Cancer Institute’s (MCI) Intake NOW program and evaluate its effects on scheduling-related outcomes among individuals seeking to establish cancer care. Methods: We conducted a retrospective data analysis before and after the MCI Intake NOW …

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

Early Palliative Care Screening Among Solid Tumor Oncology Patients, Kaitlin Lothe

Doctor of Nursing Practice Scholarly Projects

While there are extensive benefits of integration of early palliative care, referral to this specialty tends to occur late in the disease course after some form of suffering has already occurred (Hausner et al., 2021). The purpose of this DNP student’s quality improvement project was to improve care coordination and increase rate of palliative care referrals of solid tumor oncology patients through implementation of an evidence-based trigger tool for palliative care screening. Participants were recruited from a 36-bed inpatient adult medical oncology unit where identified patients meeting criteria were included in the study. Data for this study included participant demographics, …

Differences In Symptom Severity And Quality Of Life Among Patients With Cancer Using Conventional Therapies With/Without Herbal Medicines In Uganda: A Cross-Sectional Study, John Baptist Asiimwe, Prakash B. Nagendrappa, Alfred Jatho, Maud M. Kamatenesi, Esther C. Atukunda

School of Nursing & Midwifery, East Africa

Objective:

Patients with cancer experience numerous symptoms related to cancer and treatment side effects that reduce their quality of life (QOL). Although herbal medicine (HM) is used to manage such symptoms by patients in sub-Saharan Africa, data on patients perceived clinical outcomes are limited. We compared differences in QOL and symptom severity between patients with cancer using HM plus conventional therapies (i.e., chemotherapy, hormonal therapy, radiotherapy, surgery) and those using conventional therapies alone.

Methods:

This cross-sectional study included patients with cancer aged >18 years who were consecutively sampled and completed a researcher-administered questionnaire between December 2022 and January 2023. Specifically, …

Symptom Experience Of Patients With Advanced Melanoma Undergoing Immune Checkpoint Inhibitor Therapy, Natalie Jackson-Carroll

Dissertations & Theses (Open Access)

Background: Immune checkpoint inhibitors (ICIs) are novel therapeutic agents utilized in the management of advanced melanoma. Though generally well-tolerated, patients receiving ICIs experience treatment-related toxicities at varying onset and intensity. Assessment and evaluation of these toxicities and their impact on a quality of life is essential to comprehensive cancer care. Patient-reported outcomes (PRO) contribute vital data to a clinical assessment, supporting clinicians in their ability to improve outcomes. To date, there is no melanoma-specific or ICI-specific PRO measure of symptom burden available.

Purpose: The purpose of this study was to describe the symptom experience from the patient's perspective and how …

Implementation Of A Home-Based Walking Program To Address Cancer-Related Fatigue, Mary Catherine Hyatt, Karen Lasater, Michelle Payne

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Background: The non-treatment of cancer-related fatigue (CRF) in adult oncology patients on treatment is a clinical practice issue identified globally and at the local Hematology and Oncology Clinic. Despite the growing evidence supporting physical activity to address CRF, this problem remains prominent. Objective: An 8-week home-based walking program was implemented at the local clinic to address this problem. This project aimed to increase the prevalence of managing CRF and reduce the severity of CRF. Methods: With the provider's recommendation, adult oncology patients on active treatment at the Hematology and Oncology Clinic registered for the program in …

Standardized Patient Education For Patients' Initial Chemotherapy Through An Integrated Telemedicine Platform, Karen D. Dougherty

Seton Hall University Dissertations and Theses (ETDs)

Telemedicine has demonstrated a high level of satisfaction in a variety of health settings as a safe and efficient method of delivering healthcare. The purpose of this project was to implement an Advanced Practice-led Quality Improvement (QI) initiative pilot to evaluate the standardization of chemotherapy education through an integrated telemedicine platform. This Doctor of Nursing Practice (DNP) project used interventions noted in the literature review to assess and evaluate core concepts of knowledge, satisfaction, utilization, and program acceptance. This project aimed to utilize evidence-based processes to increase knowledge about the chemotherapy treatment routine, to raise awareness and develop skills to …

Implementation Of A Functional Pain Scale In An Adult Cancer Center, Kristine Pantchenko

DNP Projects

Background: Best practices include assessing functional status in addition to pain intensity in patients with cancer experiencing pain. The Defense and Veterans Pain Rating Scale (DVPRS) is an effective tool for assessing pain intensity and functional status in patients with cancer.

Objective: To improve pain assessment among outpatient oncology patients in an adult cancer center by implementing the DVPRS and evaluating patient and nurse satisfaction with this tool.

Methods: The Model for Healthcare Improvement was followed for the planning, implementation, and evaluation of this project. Nurses completed an online education module and self-assessment quiz before an in-person simulation checkoff demonstrated …

Using Debriefs To Reduce Nursing Burnout In Nurses Caring For The Oncology Population, Courtney M. Wilkes

MSN Capstone Projects

Nurses are a critical part of healthcare and make up the largest section of healthcare professionals in the United States. According to the World Health Organization (2020), there are approximately 29 million nurses and midwives globally. The increasing need for nurses is not a new discovery. According to the American Association of College of Nurses, more registered nursing jobs will be available through 2022 than any other profession in the United States. The number of nurses leaving the workforce each year has been growing steadily from around 40,000 in 2010 to nearly 80,000 in 2020. Nursing burnout is a known …

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

Psychosocial Distress Screening For Patients With Cancer: A Value-Based Approach To The Integration And Delivery Of Holistic Care, Candy Cheung

Doctor of Nursing Practice (DNP) Projects

Background: Patients with cancer (PWC) have a high prevalence of experiencing psychosocial distress as they bear the burden of the disease. Emphasis is needed on psychosocial care, as the COVID-19 pandemic negatively impacts mental health. Psychosocial distress screening is considered a standard practice by the National Comprehensive Cancer Network (NCCN), which recommends using the validated Distress Thermometer (DT) as a screening tool.

Local Problem: The DNP project ambulatory infusion clinic (AIC) site does not have a standardized distress screening tool for staff. There was a lack of awareness of an existing non-validated distress screening and little to no intervention or …

Factors Contributing To Nurse Burnout In Oncology, Caroline Withers

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Nurse burnout is a pressing concern for healthcare with significant implications for all areas of nursing and patient outcomes. However, the specialty of oncology experiences burnout differently than other specialties for a multitude of reasons. This literature review aims to determine factors that contribute to nurse burnout within oncology, and identify evidence-based prevention strategies. The twenty studies included in the review underscore the crucial role of management and leadership in the prevention of nurse burnout. Further education and research are needed to better understand causes of burnout, as well as proper interventions. Interventions need to be established on a hospital …

Dnp Final Report: Psychosocial Screening For Oncology Patients, Robyn V. Beard

DNP Final Reports

Background: Patients with cancer often face severe distress related to fear of death, body disfigurement, financial stress, and lack of support system. This distress may lead to physical and emotional symptoms that bring patients to seek care at emergency departments, delay care or make poor health choices, and increase utilization of prescription drugs. With the already over burdened healthcare system, addressing these psychosocial needs is vital to improving patients outcomes as well as improving healthcare expenditure. Purpose: The purpose of this evidence based practice project was to improve perceived quality of life for oncology patients through detailed screening and behavioural …

Successful Components For Developing An Oncology Nurse Residency Program: An Integrative Review, Andi Johnson

Master of Science in Nursing Final Projects

Problem Identification

Residency programs for newly licensed registered nurses (NLRNs) have become an integral part of the new nurse’s transition to professional practice, improving resilience and retention of the NLRN. The goal of this integrative review is to highlight concepts and components that have been successfully incorporated into NLRN residencies and provide nursing leaders with actionable guidance to incorporate into facility-based oncology nurse residencies.

Literature Search

An integrative review using Whittemore and Knafl’s approach was conducted in accordance with principles of thematic analysis established by Toronto and Remington.

Data Evaluation

Eighteen records were included. As few research articles were found …

Making Wishes Known: An Evidence-Based Practice Project For Advanced Care Planning In Oncology, Hazel Torres

Student Scholarly Projects

Practice Problem: An advance directive is a tool that patients use to maintain control of their care, plan for potential life events, identify their health proxy and communicate their wishes with their healthcare team. Despite the stated importance, the percentage of patients with completed advance directives in the Oncology clinic was less than 10%. This meant that the majority of patients did not have the tools to make their wishes known to the healthcare team.

PICOT: The PICOT question that guided this EBP project is In adult oncology patients within the outpatient setting, does implementing a formal advanced …

Cancer Risk Assessment: Implementation Of A Standardized Tool To Identify Women At Risk For Hereditary Cancer Syndrome, Gillian Harris, Karen Lasater

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background

Though literature identifies improved patient survivability with use of cancer genetic testing (CGT), routine use of risk assessment and referral to genetic services by oncologists remains low.

Objectives

To increase the number of patients identified as being at risk for hereditary cancer syndromes (HCS) and the number of patients sent for genetic counseling in a gynecologic/oncology office.

Methods

Ambry Genetics’ “AVA” (Ambry’s Virtual Assistant) screening tool was implemented and sent to all new patients visiting the office for any reason to assess their risk for HCS. Pre- and post-implementation rates of risk identification and referral to genetic services were …

Oncology Nurse Hazardous Drug Safe Handling Competencies, Jacob N. Woller

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Healthcare workers are potentially exposed to hazardous drugs (HDs) in the workplace, especially with chemotherapeutics used in oncologic treatment. Exposure to HDs increases the risk of adverse health effects. Personal protective equipment (PPE) as one control to prevent exposure. A Northeast academic medical center required implementation of annual competencies on HDs to comply with national standards detailed in United States Pharmacopeia (USP) Chapter 800. This project sought to evaluate the effectiveness of this HD competency and evaluate the PPE practices of healthcare workers who are frequently involved with HDs

Methods: A hands-on HD annual competency was developed …

The Efficacy Of The Role Of Therapeutic Play In Alleviating Pain Or Anxiety In Pediatric Cancer Patients, Savannah B. Duke

Honors Undergraduate Theses

Aim: To evaluate the efficacy of therapeutic play in alleviating pain or anxiety in the pediatric cancer patient.

Background: Therapeutic play is an intervention often incorporated within the care of pediatric cancer patients and children with other disease processes to promote well-being. Even though play therapy is supported by research, nurses have the option to implement nursing care interventions in a play-like manner. Therapeutic play is an individualized technique that provides an intentional opportunity for children to express their emotional responses in a controlled environment.

Method: The databases used in this search included CINAHL, MEDLINE, APA PsycINFO, ERIC, and Education …

Implementing A Health-Related Quality Of Life Assessment Tool In An Outpatient Hematology/Oncology Clinic: A Pilot Quality Improvement Project, Jennifer Holl

DNP Scholarly Projects

BACKGROUND: Although overall and disease-free survival remain the goals of cancer care, health-related quality of life (HRQOL) during and after treatment is increasingly acknowledged as vital to the patient’s outcomes. The purpose of this project was to identify and implement a valid, reliable HRQOL assessment tool into daily clinical practice in an outpatient hematology/oncology clinic at a 25-bed critical access hospital in rural New Hampshire.

METHODS: This project used a methodological design. Descriptive and inferential statistics, plus qualitative analysis were used to determine results. Three nurses and seven patients participated in this quality improvement project.

INTERVENTIONS: The interventions …

Physical Activity Assessment And Staff Education For Oncology Nurses, Laurie Jean Tyer

Walden Dissertations and Doctoral Studies

Physical activity and mobility are key indicators of treatment and disease tolerance in cancer patients. Patients are living longer during and after cancer treatment, and staying active prevents many side effects of the disease and the treatment. Staying mobile also prevents some conditions from occurring including bone and muscle loss. A nursing educational platform was identified as a need in the facility site’s cancer center on the importance of patients staying physically active throughout cancer treatment. Nurses did not feel confident to coach patients on their activity levels which was an identified gap in their nursing practice. A nursing educational …

Examining The Impact Of A Protein Intervention To Improve Outcomes In Frail Perioperative Candidates: A Feasibility Study, Anna M. Rose

DNP Projects

Background: Frailty is a syndrome or grouping of clinical characteristics that collectively increases one’s vulnerability to acute and external health stressors. Higher rates of frailty are present in oncology surgical patients and is a predictor of postoperative complications, as well as increased morbidity and mortality. Long- and short-term survival of surgical oncology patients is worse in frail patients than robust patients. Prehabilitation interventions during the planning phase of surgical intervention may serve to mitigate already known health concerns prior to inflicting the stressor that is surgical intervention.

Purpose: To measure the feasibility of an educational prehabilitative nutritional intervention aimed at …

Improving Patient Health Literacy: Implementation Of Health Literacy Tool & Hematology Oncology Patient Education Checklist, Ala'a Samih Mitoubsi, Karen Lasater

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Purpose: Increase health literacy and communication using a tool with a discharge checklist to facilitate communication and understanding among patients, physicians, and nursing staff.

Background and significance: In the United States, 90 million people are affected by low health literacy impairing their ability to understand and comprehend health information (Institute of Medicine et al., 2004). Another 40 million Americans have difficulty reading complex texts that makes reading health information difficult (Institute of Medicine et al., 2004). The Affordable Care Act emphasizes the need for increased self-care as a key strategy for improving health care costs and improving the quality …

Effects Of Dance/Movement Therapy On Pediatric Oncology Patients, Kaitlin Callorina

Nursing | Senior Theses

Pediatric nursing specializes in caring for patients from birth through adolescence; therefore, pediatric nursing can be spiritually challenging but rewarding. This thesis will explore the questions:

• Does dance/movement therapy have the potential to improve the quality of life for children who are diagnosed with cancer?
• How does dance/movement therapy change the quality of life in pediatric cancer patients throughout their diagnosis and treatment?

To aid in answering these questions, this thesis will examine various research articles related to dance/movement therapy and other creative arts therapy as complementary medicine and integrating the activity into nursing care. Children who are diagnosed and …

Addressing The Psychosocial State Of High-Risk Individuals Undergoing Hereditary Cancer Screening By Advanced Practice Registered Nurses (Aprns) In The Community Oncology Setting, Aquilina Kerubo Thompson

Electronic Theses and Dissertations

Abstract

Neoteric advances in genetics make it possible to define genetic risk in cancer, and there should be methods in place to provide comprehensive genomic care with oncology advanced practice registered nurses bridging this gap. The current scope of nursing practice stipulates genetic and genomic literacy; however, there remains a deficit among advanced practice registered nurses in identifying and addressing psychosocial distress during the genetic cancer risk assessment process. Oncology advanced practice registered nurses must be equipped with the knowledge that the genetic cancer risk assessment also involves protecting patients from the psychosocial repercussions of carrying a hereditary cancer gene …

Examining Provider-Related Factors Associated With Role Competence In Shared Decision Making In Oncology Nurses, Alexandria Tarvainis

College of Science and Health Theses and Dissertations

Abstract

Purpose: To examine provider-related factors associated with higher levels of competence in shared decision-making (SDM) in oncology nurses.

Design: This study is a retrospective secondary data analysis of SDM survey data collected from 230 participants (oncology nurses that are active members of the Oncology Nursing Society) during February 2017 to September 2017.

Methods: Data collected from oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest. Participants completed an online or mail survey on the following: knowledge, attitudes, communication, and adaptability which scores were derived from a 5-point …

Diabetes In The Oncology Setting Webinar Series, Jennifer Williams, Denise A. Palma, Michael Rizk Msn, Aprn, Fnp-C, Bc-Adm

2021 Education Week Posters

Department of Endocrine Neoplasia and Hormonal Disorders