The CDC has launched a comprehensive initiative designed to reduce the risk of life-threatening infections in persons with cancer who are undergoing chemotherapy. According to the agency, one out of every 10 cancer patients receiving this treatment acquires an infection that requires a hospital visit.
The program, “Preventing Infections in Cancer Patients,” includes resources for patients, caregivers, and health care providers. One of the featured materials for clinicians is a poster reminding emergency department (ED) personnel that fever in a person who is undergoing chemotherapy should be managed as an emergency. The poster points out that a fever may be the only sign of infection, and a minor infection can quickly become serious in this patient population.
Another poster, designed for patients, conveys a similar message. Patients are instructed to call their clinician right away if they develop a fever and to tell ED personnel immediately that they have a fever, they have cancer, and they are receiving chemotherapy. The poster also suggests patients should ask their clinician at what point during the chemotherapy cycle their white blood cell count (WBC) is likely to be the lowest, so they know when they are at greatest risk of infection.
The initiative also addresses outpatient facilities. More than 830,000 persons with cancer receive chemotherapy in oncology clinics each year, and they are at risk for developing an infection that may lead to hospitalization, a disruption in the chemotherapy schedule, and even death. Citing a need for greater understanding and implementation of basic infection-prevention guidance in outpatient oncology clinics, the program materials refer clinicians to the CDC 2011 guidelines, Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care.
The program’s Web site provides information on infection prevention based on the person’s risk for developing neutropenia, the most serious hematologic toxicity during cancer treatment with chemotherapy. The section, “3 Steps Toward Preventing Infections During Cancer Treatment,” features an evidence-based, interactive online program designed to help assess a cancer patient’s risk for both low WBC during chemotherapy and subsequent infections.
The assessment can be printed and completed or completed online. The tool is not for patients who have undergone or will undergo a stem cell transplant or bone marrow transplant. After the questionnaire is completed, patients will receive messages designed to educate them about staying healthy while undergoing treatment.
Clinicians can also download a neutropenia fact sheet for their patients. The sheet acknowledges that neutropenia cannot be prevented, but offers tips on reducing the risk of acquiring an infection while WBC is low. Patients are advised to keep their hands and body clean, avoid contact with sick people, and carefully wash and cook their food. In addition, the patient is advised to
- Use gloves for gardening
- Get the seasonal flu shot as soon as possible
- Use a soft toothbrush on teeth and gums and use a mouthwash to prevent oral sores, if clinician recommended.
A 3-minute podcast features an oncologist discussing the importance of infection prevention during chemotherapy treatment. ONA