Congress Abstracts 2003

77

NEUTROPENIA IN ONCOLOGY PATIENTS: STANDARDIZING AN EDUCATION-AL APPROACH AND MEASURING OUTCOMES. Judy Finkler, RN, BSN, OCN^®, Oconomowoc Memorial Hospital, Oconomowoc, WI; and Catherine Rapp, RN, MS, AOCN^®, Mary Pat Johnston, RN, MS, AOCN^®, Patty LeRoy, RN, OCN^®, and Patricia Walden, RN, OCN^®, Waukesha Memorial Hospital, Waukesha, WI.

Despite advances in supportive care for patients receiving cancer treatments, life-threatening infections related to chemotherapy-induced neutropenia continue to place them at risk. Patient education is critical to prevention, early detection, and successful patient outcomes. The purpose of this project was to standardize a consistent approach to educating patients about chemotherapy-induced neutropenia across multiple oncology settings. Several factors influence patient’s understanding of what is taught, including oncology nurse expertise and patient preferred learning style. A survey, assessing patient understanding of key elements of neutropenia teaching, was developed and distributed to patients receiving chemotherapy treatment (N = 79) in a dedicated inpatient unit and two medical oncology clinics. While the majority of oncology patients had a thermometer, 32% of patients did not know when to take their temperature, and 60% of patients were not able to state when to call their physician or oncology nurse. In addition, 50% of patients did not know how to contact their physician after clinic hours; 33% of patients did not know the signs and symptoms of an infection; and 41% of patients were not able to describe self-care measures. The findings supported the need to develop a standardized approach, differentiating two categories: 1) ALL patients receiving chemotherapy, and 2) the high risk/febrile neutropenia patient. For all patients receiving chemotherapy, key interventions included distributing thermometers, reviewing how and when to use thermometers, creating refrigerator magnets with after-hours contact numbers, and utilizing a self-care after chemotherapy teaching tool. The high risk/febrile neutropenia patients were identified as those patients with diagnoses of leukemia, lymphoma, or sarcoma, as well as patients who had a stem cell transplant or prior episode of febrile neutropenia. A more detailed tool was developed to address rationale for concern, when to be concerned, length of risk, how to reduce risk, and what to do if fever or infection develop. Full implementation of the project is planned for October, with staff education about this new simplified, standardized approach. The survey will be repeated to measure the impact of this project in December 2002.