Oral Chemotherapy Protocol Increases Documentation of Patient Education, Adherence

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WASHINGTON, DC—Preliminary data from the first month of an ongoing clinical inquiry project to develop a comprehensive Oral Chemotherapy Nursing Practice Protocol show increases in documentation of patient education, follow-up calls and early symptom assessment, and adherence monitoring, a study presented at the Oncology Nursing Society (ONS) 38th Annual Congress has found.

These findings provide evidence to support “utilization of nursing standards to improve care for patients receiving oral chemotherapy,” noted Heejin Kim, RN, DNPc, of Wayne State University, Detroit, MI.

Previously, the institution's benchmarking data showed inconsistencies in nursing procedure, adherence monitoring, and documentation of care for this patient population, suggesting a standardized nursing protocol was needed.

The objectives of the project included developing the protocol—based on the Iowa Model of Evidence-Based Practice to Promote Quality care—for patients undergoing oral chemotherapy and pilot testing the protocol in an outpatient gastrointestinal oncology clinic at Karmanos Cancer Center over 2 months using continuous quality improvement monitoring.

The evidence-based practice team convened in September 2012 with five oncology nurses. “The Oral Chemotherapy Nursing Practice Protocol was developed based on a review of literature and analysis of the current practice patterns,” Kim noted. “This newly developed evidence-based protocol focuses on patient education, symptom assessment/management with follow-up calls, continuous adherence monitoring, and nursing documentation.” The team is evaluating the protocol by changes in rates of these parameters.

In October 2012, baseline data were collected retrospectively via 50 chart audits; in November 2012, 1 month after the protocol was implemented, data were collected from 57 charts; the study continued through December 2012.

Documentation of patient education increased 84.3%; follow-calls and early symptom assessment by 67.7%, and adherence monitoring by 42.4%.

The clinical inquiry project “demonstrates the process of translating research findings into nursing practice for patients receiving oral chemotherapy,” Kim stated. “If the trend in quality monitoring continues to improve, the project will be implemented throughout the facility.”

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