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THE NURSING ROLE IN THE MANAGEMENT OF STEREOTACTIC RADIOSURGERY FOR BRAIN
TUMORS. Elisa Mangarin, OCN®, BSN, and Ethel Law, RN, BSN, NP, Memorial
Sloan-Kettering Cancer Center, New York, NY.
Stereotactic radiosurgery (SRS) delivers a single high dose of focused
radiation to a primary or metastatic brain tumor. It is indicated for
patients who have ¼ 3 well-circumscribed lesions of < 4 cms
each that are not easily accessed by surgery. A stereotactic head frame,
secured by pins to the skull, is used for localization of the tumor and
immobilization during treatment. The precision of this treatment minimizes
side effects to normal brain tissue. SRS is an ambulatory procedure, and
patients may resume normal activities within 24 hours post treatment.
SRS has good clinical outcomes, is cost-effective, and has minimal adverse
effects on quality of life. As a result, it is increasingly being offered
to patients as a treatment option.
Safe and effective treatment with SRS requires a multidisciplinary approach
and includes clinicians from radiation oncology, neurosurgery, neurology,
physics, and MRI imaging. Radiation oncology (RO) nurses, as part of the
SRS team, have a unique role and responsibility in caring for patients
receiving this treatment. The RO nurse’s involvement begins at consultation,
assessing the patient for factors that may impact on treatment, and preparing
the patient and family for the procedure with one-on-one teaching, supplemented
by viewing a videotape and reading an educational booklet. Once the treatment
date is established, the RO nurse coordinates scheduling with the radiology
and neurosurgery services. On the treatment day, the nurse cares for the
patient while the treatment is planned and administered, and provides
and reviews discharge instructions, including a Decadron taper calendar.
The nurse calls the patient the day after the procedure to assess for
acute side effects and medication compliance.
To ensure continuity of care throughout the SRS experience, from consultation
to treatment completion, radiation oncology nurses developed an SRS flow
sheet. This systematically lists all steps in the process, ensures safety,
especially when multiple nurses are involved in the patient’s care,
and enables easy patient care documentation.
This presentation will describe SRS, the RO nursing role, and the tools
that have been developed by the RO nurse to assist in role implementation.
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