Volume 5, Issue 1, April 2007
The Neutropenia SIG Newsletter is underwritten through a grant from Amgen Inc.
     
Join Us at the Neutropenia SIG Congress Planning/Networking Meeting

Arlene Davis, RN, MSN, AOCN®
Gainesville, FL
arlene.davis@med.va.gov

If you are attending the ONS 32nd Annual Congress in Las Vegas, NV, I hope you have marked your calendar to attend the Neutropenia SIG planning/networking meeting on Tuesday, April 24, from 5:15–6:30 pm (South Pacific Ballroom C/D, Table 4 ). A member of the Advanced Nursing Research SIG will be joining our meeting to discuss with us the development of a collaborative research project. I am excited about this collaboration because our SIG is striving to identify evidence-based practices in caring for patients with neutropenia, yet many of us do not have the expertise or experience in conducting research. Please give me some input on what research questions you would like to see addressed. You can send me your ideas via e-mail to arlene.davis@med.va.gov.

I want to call your attention to several Congress sessions that might interest you. "ONS PEP Talk," Discussion Session 2, will be held on Tuesday, April 24, at 1:30 pm. During this interactive session, participants will learn how to use the ONS Putting Evidence Into Practice (PEP) cards. Remember, one of the ONS PEP cards addresses interventions for preventing infection in people with cancer. Alison Gardner, PhD, RN, a SIG member and our newsletter coeditor, is one of the speakers at Instructional Session 11, "Current Trends in Neutropenic Fevers and Sepsis." This session will be held on Wednesday, April 25, at 10:30 am and will address the evaluation and management of neutropenic fevers. Finally, at 2:30 pm on Wednesday, April 25, care of long-term immunocompromised patients will be addressed at Instructional Session 13, "Care of the Immunocompromised Patient with Hematologic Disorders." This session will be repeated on Thursday, April 26, at 10:30 am.

At the close of Congress this year, my role will change to ex-officio as Nancy Hayes, RN, MSN, AOCN®, takes over the role of coordinator. Although my role as coordinator will end, my service to the Neutropenia SIG will continue.

 
The Neutropenia SIG Newsletter is produced by members of the
Neutropenia SIG and ONS staff and is not a peer-reviewed publication.

Special Interest Group Newsletter  April 2007
 
   

Nurses With Artificial Nails May Contribute to Nosocomial Infections

Lourdes Duque, RN, MSN, AOCNP
East Orange, NJ
lourdes.duque@med.va.gov

The use of artificial nails has become a popular fashion trend, and many healthcare workers, particularly nurses, are joining in. However, researchers have shown that the colony counts on artificial nails are greater than the colony count on natural nails.

Normal human skin is colonized with bacteria. Different areas of the body have varied total aerobic bacterial counts. Transient and resident floras exist on the hands and nails. Transient flora colonizes the superficial layers of the skin and can be removed by hand washing, whereas resident flora are attached to the deeper layers and are more resistant to removal. A study by McNeil, Foster, Hedderwick, and Kauffman (2001) was conducted to determine differences in micro flora on the nails of healthcare workers wearing artificial nails compared to those with natural nails. Cultures were obtained from 21 healthcare workers wearing artificial nails and 20 control healthcare workers with natural nails before and after using microbial soap or alcohol-based gel. Before cleansing with soap, 86% of healthcare workers with artificial nails had a pathogen isolated (gram-negative bacilli, staphylococcus aureus, or yeasts), compared with 35% of controls (p = 0.003); a similar difference was noted before hand cleansing with gel (68% versus 28%; p = 0.03).

The study depicts a significant increase in the number of pathogens found on healthcare workers with artificial nails than on controls. This clearly points out that artificial acrylic nails can contribute to the transmission of pathogens in any type of healthcare setting, whether in a highly sterile areas like the operating room or unsterile areas like outpatient clinics or inpatient units. Artificial nails have been linked to poor hand washing practices and more tears in gloves. Nurses with artificial nails can transmit pathogens through simple contact with patients like assisting in morning care, taking vital signs, or caring for wound dressings. The use of artificial nails by nurses should be highly discouraged because the vulnerable victim in the transmission of pathogen is the patient, especially the immunocompromised.

Reference

McNeil, S.A., Foster, C.L., Hedderwick, S.A., & Kauffman, C.A. (2001). Effect of hand cleansing with antimicrobial soap or alcohol-based gel on microbial colonization of artificial fingernails worn by health care workers. Clinical Infectious Diseases, 32, 367–372.

 
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Special Interest Group Newsletter  April 2007
 
   

Putting Evidence Into Practice
ONS PEP Resources Provide Quick Information on Evidence-Based Interventions

Margaretta S. Page, MS, RN, primary author of the ONS Putting Evidence Into Practice (PEP) card on sleep-wake disturbances and its corresponding article in the Clinical Journal of Oncology Nursing, recounts her first-hand experience using the PEP resources. Click here for the article.
 
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Special Interest Group Newsletter  April 2007
 
   

Neutropenia Is Not Always Related to Chemotherapy

 Janet Cogswell, RN, MSN, AOCN®
East Orange, NJ
janetcogswell@hotmail.com

Neutropenia in the practice of oncology nursing is associated with myelosuppressive chemotherapy or diagnoses such as leukemia. However, other etiologies of neutropenia are part of a differential diagnosis in hematology. These neutropenias also may result in an increased risk for infection.

Neutropenias can be categorized as acquired or congenital. Acquired neutropenias include drug-induced neutropenia, nutrition-induced neutropenia, infection-related neutropenia, immune-associated neutropenia, and chronic idiopathic neutropenia. Congenital neutropenias include cyclic neutropenia and Kostmann syndrome.

Neutropenias induced by myelosuppressive chemotherapy are familiar. However, other drugs also may cause neutropenia by mechanisms other than bone marrow suppression. Many medications have been implicated, including some widely prescribed drugs such as cimetidine, hydrochlorothiazide, and allopurinol. Poor nutrition and alcohol intake is associated with pancytopenias, including neutropenia. Infections, usually viral, can lead to neutropenia through direct infiltration of precursor cells or sequestering from an enlarged spleen. Autoimmune neutropenia can be triggered by infection or system autoimmune disease. Antineutrophil antibodies or an enlarged spleen is a possible mechanism of action. Chronic idiopathic neutropenias are not associated with bone marrow dysfunction or immune response. They usually have no clinical symptoms.

Cyclic neutropenia is a congenital disorder of adults that results in a 21-day pattern with a nadir of near 0 and a peak near normal. The monocytes cycle inversely to the neutrophil pattern. The risk of infection depends on the nadir value.

Some of these conditions such as cyclic neutropenia may be treated with colony-stimulating factors. However, all patients can benefit from health education regarding preventative measures during periods of neutropenia.

Bibliography

Dale, D.C., Cottle, T.E., Fier, C.J., Bolyard, A.A., Bonilla, M.A., Boxer, L.A., et al. (2003). Severe chronic neutropenia: Treatment and follow-up of patients in the Severe Chronic Neutropenia International Registry. American Journal of Hematology, 72(2), 82–93.

Williams, W.J., Beutler, E., Erslev, A.J., & Lichtman, M.A. (Eds.). (1990). Hematology (4th ed.). New York, NY: McGraw-Hill.

 
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Special Interest Group Newsletter  April 2007
 
   

News From the ONS National Office
Celebrate Oncology Nursing Month in May 2007

Oncology Nursing Month recognizes oncology nurses, educates the public about the specialty, and provides you with an opportunity to hold special educational events and celebrate the accomplishments of oncology nurses. Become an ambassador for your profession. You can educate your patients and the public about the importance of oncology nursing! Learn more at www.ons.org/nursingmonth07.

ONS Virtual Communities
The ONS Virtual Communities are located in the Membership area of the ONS Web site at www.ons.org/membership/chapters.shtml. This page is the gateway to the ONS Chapter, Student, and Diversity Virtual Communities as well as focus groups and special interest groups. Be sure to check out the ONS Virtual Communities.

Registration Now Open for the ONS 32nd Annual Congress
Everyone's a winner at the ONS 32nd Annual Congress, held April 24–27 in Las Vegas, NV. You can earn approximately 20 contact hours at Congress, the number-one conference for cancer nurses. Learn more at www.ons.org/meetings/congress07.

 
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Special Interest Group Newsletter  April 2007
 
   

Articles of Interest
Neutropenia SIG Members May Enjoy These Recently Published Articles

 Check out the Oncology Nursing Forum (ONF) and Clinical Journal of Oncology Nursing (CJON) for interesting articles about neutropenia.

For access to the fulltext versions of these and other ONF and CJON articles, visit the Publications area of the ONS Web site.


 
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Special Interest Group Newsletter  April 2007
 
   

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Join a Virtual Community
A great way to stay connected to your SIG is to join its Virtual Community. It's easy to do so. All you will need to do is

  • Log on to the ONS Web site (www.ons.org).
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  • Then, click on "Chapters, SIGs & Virtual Communities."
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  • Type the required information into the text fields as prompted.
  • Click "Join Group" (at the bottom right of the text fields) when done.
Special Notices
  • If you already have log-in credentials generated from the ONS Web site, use this information instead of attempting to generate new information.
  • If you created log-in credentials for the ONS Web site and wish to have different log-in information, you will not be able to use the same e-mail address to generate your new credentials. Instead, use an alternate e-mail address.

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All members are encouraged to participate in their SIG's discussion forum. This area affords the opportunity for exchange of information between members and nonmembers on topics specific to all oncology subspecialties. Once you have your log-in credentials, you are ready to subscribe to your SIG's Virtual Community discussion forum. To do so,

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Participate in Your SIG's Virtual Community Discussion Forum
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As an added feature, members also are able to register to receive their SIG's announcements by e-mail.

  • From your SIG's Virtual Community page, locate the "Sign Up Here to Receive Your SIG's Announcements" section. This appears above the posted announcements section.
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Special Interest Group Newsletter  April 2007
 
   

Neutropenia SIG Officers

Coordinator (2005-2007)
Arlene Davis, RN, MSN, AOCN®
Gainesville, FL
arlene.davis@med.va.gov

Coordinator-Elect (2006-2007)
Nancy Hayes, RN, MS, AOCN®
Lutz, FL
nhayes@amgen.com

Coeditor
Janet Cogswell, RN, MS, CNS, AOCN®
East Orange, NJ
janetcogswell@hotmail.com

 

Coeditor
Alison Gardner, PhD, RN
Houston, TX
agardner@mdanderson.org

ONS Publishing Division Staff
Elisa Becze, BA
Copy Editor
ebecze@ons.org

Know someone who would like to receive a print copy of this newsletter?
To print a copy of this newsletter from your home or office computer, click here or on the printer icon located on the SIG Newsletter front page. Print copies of each online SIG newsletter also are available through the ONS National Office. To have a copy mailed to you or another SIG member, contact Membership/Leadership Administrative Assistant Carol DeMarco at cdemarco@ons.org or 866-257-4ONS, ext. 6230.

Mission
The mission of the Neutropenia SIG is to provide networking and educational opportunities to oncology nurses and raise awareness of the impact on oncology patients.

To view past newsletters, click here.

ONS Membership/Leadership Team Contact Information

Angie Stengel, MS, CAE, Director of Membership/Leadership
astengel@ons.org
412-859-6244

Diane Scheuring, MBA, CMP, Manager of Member Services
dscheuring@ons.org
412-859-6256

Carol DeMarco, Membership/Leadership Administrative Assistant
cdemarco@ons.org
412-859-6230

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
125 Enterprise Dr.
Pittsburgh, PA 15275-1214
866-257-4ONS
412-859-6100
www.ons.org

 
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