 |
| Volume
1, Issue 2, August 2003 |
| |
| Survey Update SIG Calculates Results From the Neutropenic Precautions Survey  Bonnie
Wivell, RN, BSN, OCN®Denver, CO BnJsAbode@aol.com One of the problems identified early in the development of the Neutropenia SIG was the lack of nursing research in the care of patients with neutropenia. Many of our practice guidelines appeared to be based on theory and varied depending on different practice settings. In 2001, the Neutropenia Focus Group felt that an assessment of current practices in the care of patients with neutropenia was an important step for identifying areas of future research. A survey was designed, and, in August 2002, it was mailed to 1,500 nurse members of ONS. The goals of the study were threefold. First, we wanted to determine what parameters nurses use to identify patients as neutropenic. Second, we wanted to discover what neutropenic precaution practices and policies were used at different institutions. Last, we wanted to identify common instructions and restrictions taught to patients with neutropenia regarding home care and when to seek medical attention. Four hundred twenty-one people responded (28%); the data were analyzed in March 2003 and presented as a poster session at the ONS 28th Annual Congress in May. Table 1 shows the percentage of respondents who answered positively to various questions in the survey. As demonstrated by the survey results, a wide variation exists in clinical practices and patient education with regard to neutropenic precautions. Hence, the study assisted in generating ideas for future research, such as examining IV or central venous catheter tubing and dressing changes specific to patients with neutropenia or the timing and initiation of IV antibiotics in febrile episodes and patient outcomes; we now can examine other current practices used to care for patients with neutropenia (e.g., wearing masks, not permitting flowers in room). We have started gathering data to assist us in identifying what research projects have been completed already, and then we can begin working and building on this data to reach our ultimate goal of establishing national standards in caring for patients with neutropenia. |
 |
|
Special Interest Group Newsletter August 2003 |
|
Update on Our Logo  Our new logo is a representation of a person’s white cell nadir after chemotherapy. Often, the lowest cell count is 7–10 days after chemotherapy treatment. The lines of our logo reflect the lines of a chart graphing the neutrophil response to chemotherapy. This logo won by about six votes. The runner-up was the ONS lantern with a neutrophil in the flame. Also under consideration were a “mighty neutrophil” (a neutrophil with arms and legs holding up a heavy weight) and a neutrophil in the center of a sun.
|
|
|
Special Interest Group Newsletter August 2003 |
|
ATAQ Moves on to Europe  Teresa
Knoop, MSN, RN, AOCN®Brentwood, TN teresa.knoop@vanderbilt.edu An abstract authored by Annette Parry-Bush, RN, associate for the Education Cancer Care Issue Team at ONS in Pittsburgh, PA; and Debbie Wujcik, RN, MSN, AOCN®, and me, both of the Vanderbilt-Ingram Cancer Center in Nashville, TN, recently was submitted to the European Cancer Conference. The abstract, titled “The Appropriate Treatment Assures Quality (ATAQ) Project: Improving the Management of Neutropenia,” reviews the ATAQ neutropenia initiative, focusing on the professional education arm of the project. The abstract was accepted for a poster presentation at the European Cancer Conference (ECCO 12) and will be displayed in a poster session that focuses on supportive care. The ECCO 12 conference will be held in Copenhagen, Denmark, from September 21–25, 2003.
|
|
|
Special Interest Group Newsletter August 2003 |
|
Neutropenia Myths and Facts Are Revealed
Lindenhurst, NY Barbara@computer.org Myth: If a patient with chemotherapy-induced neutropenia develops neutropenic fever, it is because he or she did not follow neutropenic precautions. Fact: Although following neutropenic precautions, especially strict hand washing, is felt to be important in preventing infections in patients with neutropenia, new theories are emerging suggesting that neutropenic precautions play much less of a role than previously thought. In fact, most infections in patients with neutropenia are felt to be a result of an imbalance in their normal bacteria flora, which causes one bacteria to dominate and its overgrowth results in infection. More research is needed to study whether following neutropenic precautions actually reduces the rate of neutropenic fever.
|
|
|
Special Interest Group Newsletter August 2003 |
|
Editor's Message What Are Your Thoughts on Dose-Dense Regimes and Neutropenia?
Lindenhurst, NY Barbara@computer.org The next newsletter will focus on neutropenia with dose-dense chemotherapy regimes. Please consider contacting me with a paragraph or two about how you are managing neutropenia with patients on dose-dense regimes at your practice. Points to ponder: Are you using granulocyte-specific colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, or pegfilgrastim? If you are administering daily injections, how often are you giving them? What absolute neutrophil count do your patients need to have at the beginning of their cycles to be treated? What is your opinion of how patients are tolerating these regimes? Is neutropenia a significant side effect, and what are some of the other side effects seen with these regimes? I will mail a brief survey to everyone on our contact list asking some of these questions. Please take the time to respond. In this way, the newsletter can reflect all of our knowledge and talents.
|
|
|
Special Interest Group Newsletter August 2003 |
|
Coordinator's Message Check the SIGs Virtual Community Frequently for Updates
Denver, CO BnJsAbode@aol.com Greetings, everyone. Hope this finds you all well. Life is busy, and time passes so quickly. We all have many responsibilities—home, career, and family. Sometimes, we have difficulty trying to keep from getting overwhelmed by all of life’s demands and obligations. I often feel stressed these days, but I can breathe a small sigh of relief now that the ONS 28th Annual Congress is over; however, work still remains to be done. Next year’s Congress will be here before we know it. I am so thankful to Arlene Davis, RN, MSN, AOCN®, our co-coordinator, for all of her assistance during and after the planning meeting at Congress this year, especially typing and formatting the minutes. The meeting was a big success. We had a great turnout, and we were able to complete the development of our strategic plan. We are off to a great start as a SIG. I would like to encourage each of you to go to ONS Online and view our Virtual Community Web page. Our page administrator, Sherry Wiedow, RN, will begin posting some of our SIG information. I developed a Microsoft® PowerPoint® program in which I presented the survey results at the SIG Leadership Workshop the Wednesday before Congress, and we will attempt to have that presentation posted on the Virtual Community for you to view in the near future. You also will be able to find our newsletters on the Virtual Community, and our strategic plan eventually will be posted there, as well. If you have any announcements of any kind (e.g., upcoming educational opportunities), please feel free to contact Sherry at wiedow.sherry@marshfieldclinic.org so she can get the announcements posted on the Web. I want to remind everyone that we are in the process of collecting any research or performance-improvement project information from cancer centers nationwide. If you work in or near a cancer center, please make some inquiries and forward any information you find to me by September 1, 2003 (see SIG Officers page for all contact information). You most likely will find this information in the research department (for research projects) or in quality and outcomes (for performance-improvement projects). Any and all contributions are greatly appreciated. If you have any questions or need more information about this endeavor, please do not hesitate to contact me. Well, this greeting is short, but I am pressed for time. Please review the summary of the survey results because I think you will find them to be quite interesting. Hope you all are having a great summer.
|
|
|
Special Interest Group Newsletter August 2003 |
|
New Q Code Is Issued for Billing for Pegfilgrastim  The
Centers for Medicare and Medicaid Services (CMS) have issued a new Q code
for billing Neulasta® (pegfilgrastim, Amgen Inc., Thousand
Oaks, CA). Q4053 (“Injection, pegfilgrastim, 1 mg”) is effective
for dates of service on or after July 1, 2003. Providers will need to
bill “6” in the units field on claim forms to bill for an
entire 6 mg Neulasta prefilled syringe. Based on CMS guidance, Q4053 will
replace J3490, the miscellaneous Health Care Common Procedure Coding System
code that most providers have been using to bill for Neulasta to date.
Also, billing Medicare for Neulasta administered in the hospital outpatient setting
now should be done using Q4053 in place of C9119. Some private insurers,
however, may continue to request that providers bill for Neulasta using
S0135 (“Injection, pegfilgrastim, 6 mg”).
|
|
|
Special Interest Group Newsletter August 2003 |
|
Know
someone who would like to receive a print copy of this newsletter? ONS
Membership/Leadership Team Contact Information Diedrea White, BA, Manager
of Member Relations and Diversity Initiatives Carol
DeMarco, Membership/Leadership Administrative Assistant The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability. Oncology
Nursing Society
|