Medicine and Health Sciences Commons^™

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 …

Single Low-Dose Targeted Bevacizumab Infusion In Adult Patients With Steroid-Refractory Radiation Necrosis Of The Brain: A Phase Ii Open-Label Prospective Clinical Trial, Shervin R. Dashti, Robert J. Kadner, Bradley S. Folley, Jason P. Sheehan, Dong Y. Han, Richard J. Kryscio, Mary B. Carter, Lisa B. E. Shields, Brian M. Plato, Renato V. La Rocca, Aaron C. Spalding, Tom L. Yao, Justin F. Fraser

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVE There is an unmet need for safe and rapidly effective therapies for refractory brain radiation necrosis (RN). The aim of this prospective single-arm phase II trial was to evaluate the safety and efficacy of a single low-dose targeted bevacizumab infusion after blood-brain barrier disruption (BBBD) in adult patients with steroid-refractory brain RN.

METHODS Ten adults with steroid-refractory, imaging-confirmed brain RN were enrolled between November 2016 and January 2018 and followed for 12 months after treatment. Bevacizumab 2.5 mg/kg was administered as a one-time targeted intra-arterial infusion immediately after BBBD. Primary outcomes included safety and > 25% decrease in lesion volume. …

Cancer Incidence And Stage At Diagnosis Among People With Psychotic Disorders: Systematic Review And Meta-Analysis., Jared C Wootten, Joshua C Wiener, Phillip S Blanchette, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Research regarding the incidence of cancer among people with psychotic disorders relative to the general population is equivocal, although the evidence suggests that they have more advanced stage cancer at diagnosis. We conducted a systematic review and meta-analysis to examine the incidence and stage at diagnosis of cancer among people with, relative to those without, psychotic disorders. We searched the MEDLINE, EMBASE, PsycINFO, and CINAHL databases. Articles were included if they reported the incidence and/or stage at diagnosis of cancer in people with psychotic disorders. Random effects meta-analyses were used to determine risk of cancer and odds of advanced stage …

Reducing Time To Antibiotics In Patients With Neutropenic Fever On A Bone Marrow Transplant Unit, Regina Mcguire, Christopher Anand Gardner, Jordan Villars, William O'Hara, Jessica Radicke, Felicia Rivera, Jill Cristiano, Joanne E. Filicko-O'Hara, Usama Gergis, Adam F. Binder

Student Papers, Posters & Projects

Background/Methods: Timely administration of antibiotics in patients with neutropenic fever (NF) is essential for reducing morbidity and mortality among oncology patients. The optimal time to antibiotics (TTA) for patients with NF is unclear, but IDSA/ASCO guidelines recommend a median TTA within one hour of documented fever. This study focused on identifying barriers at a single academic institution to timely antibiotic administration for patients admitted to the inpatient Bone Marrow Transplant (BMT) unit, and implemented new processes to reduce median TTA to less than 60 minutes.

Methods: Chart reviews were performed to identify causes for delays in antibiotics (abx). Based on …

Cancer Patient Beliefs And Attitudes Regarding Immune Checkpoint Inhibitor Therapy, Nedal Darwish, Delaney C. Stuhr, Haily M. Datz, Halima Bakillah, Tenzin Tseky, Mohamed Manaa, Serge Dauphin

Advances in Clinical Medical Research and Healthcare Delivery

The development and widespread use of immune checkpoint inhibitors (ICIs) have advanced the field of oncology in a short period of time. Despite this, patient perception regarding this new medication class has not been adequately assessed, which may affect treatment decisions and adherence. The Belief about Medicines Questionnaire (BMQ) is a validated survey composed of 18 questions which analyzes patient’s beliefs about the necessity of prescribed medication and concern about the potential adverse events caused by the medication. General medication overuse and harm are also determined. This is the first study to utilize the BMQ for patients on ICI therapy.

Cancer Incidence And Stage At Diagnosis Among People With Recent-Onset Psychotic Disorders: A Retrospective Cohort Study Using Health Administrative Data From Ontario, Canada., Jared C Wootten, Lucie Richard, Phillip S Blanchette, Joshua C. Wiener, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: Prior evidence on the relative risk of cancer among people with psychotic disorders is equivocal. The objective of this study was to compare incidence and stage at diagnosis of cancer for people with psychotic disorders relative to the general population.

METHOD: We constructed a retrospective cohort of people with a first diagnosis of non-affective psychotic disorder and a comparison group from the general population using linked health administrative databases in Ontario, Canada. The cohort was followed for incident diagnoses of cancer over a 25-year period. We used Poisson and logistic regression models to compare cancer incidence and stage at …

Creating And Implementing A Principal Investigator Tool Kit For Enhancing Accrual To Late Phase Clinical Trials: Development And Usability Study., Kristin A Higgins, Alexandra Thomas, Nancy Soto, Rebecca Paulus, Thomas J George, Thomas B Julian, Sharon Hartson Stine, Merry Jennifer Markham, Maria Werner-Wasik

Kimmel Cancer Center Faculty Papers

BACKGROUND: Accrual to oncology clinical trials remains a challenge, particularly during the COVID-19 pandemic. For late phase clinical trials funded by the National Cancer Institute, the development of these research protocols is a resource-intensive process; however, mechanisms to optimize patient accrual after trial activation are underdeveloped across the National Clinical Trial Network (NCTN). Low patient accrual can lead to the premature closure of clinical trials and can ultimately delay the availability of new, potentially life-saving therapies in oncology.

OBJECTIVE: The purpose of this study is to formally create an easily implemented tool kit of resources for investigators of oncology clinical …

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. …

A Survey Of Interventions For Cancer Survivors Provided By Occupational Therapy Practitioners, Katie M. Polo, Mary F. Baxter

Internet Journal of Allied Health Sciences and Practice

Purpose: Currently, there is a lack of research exploring evidence-based occupational therapy intervention practices at the activity level in survivorship care, which is important to identify for future research and clinical needs of the profession. The purpose of this study was to describe what activity level interventions OT practitioners are using and report any practice trends that might exist. Method: A cross-section design was used with non-probability purposive sampling to recruit occupational therapy practitioners working with adults living with and beyond cancer. A three-phase process for survey development and implementation was used, as recommended by the literature, for improving content …

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 …

Telehealth Cancer-Related Fatigue Clinic Model For Cancer Survivors: A Pilot Randomised Controlled Trial Protocol (The T-Crf Trial), Rahul Ladwa, Elizabeth P. Pinkham, Laisa Teleni, Brigid Hanley, Gemma Lock, Jodie Nixon, Oluwaseyifunmi Andi Agbejule, Fiona Crawford-Williams, Lee Jones, Mark B. Pinkham, Jane Turner, Patsy Yates, Steven M. Mcphail, Joanne F. Aitken, Carmen P. Escalante, Nicolas H. Hart, Raymond J. Chan

Research outputs 2022 to 2026

INTRODUCTION: Cancer-related fatigue (CRF) is one of the most common and debilitating adverse effects of cancer and its treatment reported by cancer survivors. Physical activity, psychological interventions and management of concurrent symptoms have been shown to be effective in alleviating CRF. This pilot randomised controlled trial (RCT) will determine the feasibility of a telehealth CRF clinic intervention (T-CRF) to implement evidence-based strategies and assess the impact of the intervention on CRF and other clinical factors in comparison to usual care. METHODS AND ANALYSIS: A parallel-arm (intervention vs usual care) pilot RCT will be conducted at the Princess Alexandra Hospital in …

Trends In Patient Outcome Scores In Orthopaedic Oncology: A Systematic Review, David Le, Kelsey Martin, Sean C. Clark, Tae Won B. Kim

Research Day

Introduction: The field of orthopaedic oncology has trailed in defining trends in reported outcome measures (ROMs) over the last decade. Although the Musculoskeletal Tumor Society (MSTS) Score is a well-recognized ROM, new ROMs developed and established in literature have created difficulty in identifying the standard ROM within the field. The aim of our study is to identify trends in the use of ROMs in orthopaedic oncology over time, as well as the frequency and distribution among specific pathologies and orthopaedic journals.

Methods: A systematic review was conducted of all original articles reporting on topics relating to orthopaedic oncology in five …

Biologically-Inspired Nanoparticles For Oncology Applications, Aishwarya Bapat

Theses & Dissertations

Cancer is the leading cause of death in the United States and its high mortality rate can be attributed towards poor diagnosis methods and less effective therapeutic treatments. Many nanotechnology-based diagnostics and therapeutics are being developed to improve cancer patient outcomes. In this work, we have studied nanoparticles for diagnostic and therapeutic applications in cancer treatment.

In the first work, novel fluorescent NPs loaded with indocyanine green (ICG) were developed for bioimaging applications of pancreatic cancer. Targeted fluorescent nanoparticles (NPs) are being developed to image a range of cancer types with the goal to improve patient outcomes by utilizing in …

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 …

An Analysis Of The Psychological And Physical Effects Of A Physical Activity Program During In-Patient Pediatric Cancer Treatment, Zoë Winters

Undergraduate Theses

There is limited published research regarding the use of physical activity in cancer treatment programs, and even fewer in pediatric treatment plans; however, there is a common consensus that following the conclusion of cancer treatment an individual’s physical fitness has been majorly impacted. The inactivity that commonly coexists with cancer treatment often results in extended periods of time in rehabilitation programs and decreased independence. Along with the physical detriments caused by inactivity, increased dependence on others often brings about feelings of helplessness that can further cause emotional detriments. It has however been demonstrated in previous research that adding physical activity …

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 …

Crizotinib In Patients With Tumors Harboring Alk Or Ros1 Rearrangements In The Nci-Match Trial., A S Mansfield, Z Wei, R Mehra, A T Shaw, C H Lieu, P M Forde, A E Drilon, Edith P. Mitchell, J J Wright, N Takebe, E Sharon, D Hovelson, S Tomlins, J Zeng, K Poorman, N Malik, R J Gray, S Li, L M Mcshane, L V Rubinstein, D Patton, P M Williams, S R Hamilton, B A Conley, C L Arteaga, L N Harris, P J O'Dwyer, A P Chen, K T Flaherty

Department of Medical Oncology Faculty Papers

The NCI-MATCH was designed to characterize the efficacy of targeted therapies in histology-agnostic driver mutation-positive malignancies. Sub-protocols F and G were developed to evaluate the role of crizotinib in rare tumors that harbored either ALK or ROS1 rearrangements. Patients with malignancies that progressed following at least one prior systemic therapy were accrued to the NCI-MATCH for molecular profiling, and those with actionable ALK or ROS1 rearrangements were offered participation in sub-protocols F or G, respectively. There were five patients who enrolled on Arm F (ALK) and four patients on Arm G (ROS1). Few grade 3 or 4 toxicities were noted, …

Adverse Events Reporting Of Clinical Trials In Exercise Oncology Research (Advance): Protocol For A Scoping Review, Hao Luo, Oliver Schumacher, Daniel A. Galvão, Robert U. Newton, Dennis R. Taaffe

Research outputs 2022 to 2026

Introduction: Adequate, transparent, and consistent reporting of adverse events (AEs) in exercise oncology trials is critical to assess the safety of exercise interventions for people following a cancer diagnosis. However, there is little understanding of how AEs are reported in exercise oncology trials. Thus, we propose to conduct a scoping review to summarise and evaluate current practice of reporting of AEs in published exercise oncology trials with further exploration of factors associated with inadequate reporting of AEs. The study findings will serve to inform the need for future research on standardisation of the definition, collection, and reporting of AEs for …

Lymphoma With Tuberculous Granulomas, Jyoti Mohan Lal, Anila Rashid

Department of Pathology and Laboratory Medicine

Chronic granulomatous inflammation is a common finding in lymphoproliferative disorders (LPDs), but it is important to exclude coexisting mycobacterium tuberculosis (MTB) especially in patients from areas of high endemicity. This case emphasizes the relevance of performing MTB culture on bone marrow exhibiting LPD and concomitant granulomas

Breakthrough Medicines During The Covid-19 Pandemic Era, Eswara Naga Hanuma Kumar Ghali, Vijian Dhevan, Shravan K. Narmala, Meena Jaggi, Subhash C. Chauhan, Murali M. Yallapu

School of Medicine Publications and Presentations

No abstract provided.

Evaluating A Multicomponent Survivorship Programme For Men With Prostate Cancer In Australia: A Single Cohort Study, Patsy Yates, Rob Carter, Robyn Cockerell, Donna Cowan, Cyril Dixon, Anita Lal, Robert U. Newton, Nicolas Hart, Daniel A. Galvão, Brenton Baguley, Nicholas Denniston, Tina Skinner, Jeremy Couper, Jon Emery, Mark Frydenberg, Wei Hong Liu

Research outputs 2022 to 2026

Objective: To evaluate the implementation of a multicomponent survivorship programme for men with prostate cancer and their carers. Design: A single cohort study, guided by the RE-AIM framework. Setting: Multiple health services in Australia. Participants: Men with prostate cancer and their carers, and health professionals. Intervention: A 12-month telehealth programme that provided centralised and coordinated decision and information support, exercise and nutrition management, specialised clinical support and practical support to men and their carers. Data collection: Multiple sources of data including participant-reported health outcomes and experience of care, qualitative interviews, records of the programme were collected at different time points. …

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 …

Predictors Of Health Literacy Scores In The Adolescent Oncologic Population, Amber N. Jenkins

Walden Dissertations and Doctoral Studies

Recent research showed a relationship between low health literacy in adult oncology patients, poor communication with providers, misconceptions about disease and treatment options, and the inability to adhere to treatment plans. Comparative literature addressing adolescent health literacy contained insufficient evidence of these relationships. The purpose of this exploratory cross-sectional quantitative study, based on the health literacy skills framework, was to assess the health literacy of adolescents treated in the oncology department at an academic children’s hospital in Missouri to determine whether there was a significant relationship between individual health literacy scores of this population based on age, sex, number of …

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 …

The Impact Of Covid-19 On Cancer Patients, Their Carers And Oncology Health Professionals: A Qualitative Study, P Butow, P E. Havard, Z Butt, I Juraskova, H Sharpe, H Dhillon, L Beatty, P Beale, M Cigolini, B Kelly, R J. Chan, L Kirsten, Megan Best, J Shaw

IES Papers and Journal Articles

Objective: Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged.

Methods: In this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety …

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 …

Oncology Providers Barriers To Providing Quality Healthcare Services For Caribbean Women Of Color With Breast Cancer, Michelle Charmaine Garcia

Walden Dissertations and Doctoral Studies

Breast cancer is a global public health issue, and oncology healthcare providers (OHPs’) play a pivotal role in ensuring access to cancer care for their patient population. Caribbean women of color in the United States have the highest death rate of any racial or ethnic group. Strategies have been introduced to reduce this gap, and they still have not addressed the needs of Caribbean women of color, who tend to be diagnosed after developing late-stage breast cancer. No previous studies have explored OHPs' perceptions and lived experiences regarding barriers to healthcare service delivery and access for Caribbean women of color …