Congress Abstracts 2003

81

THE HEPATIC ARTERIAL INFUSION THERAPY: THE INPATIENT NURSE’S ROLE IN PREVENTING COMPLICATIONS AND MAINTAINING PATIENT SAFETY THROUGH PATIENT EDUCATION. Patricia Gabriel, RN, MSN, ANP, Donna Fitzmaurice, BSN, RN, Rita Moore, RN, and Kim Borg, RN, Memorial Sloan-Kettering Cancer Center, New York, NY.

Colorectal cancer’s most frequent site of metastases is the liver. A current therapy for treatment of liver metastasis at this NCI-designated comprehensive cancer center is the hepatic arterial infusion therapy (HAI). Nursing knowledge of hepatic physiology is essential to effectively manage this patient population. It is imperative for nurses to educate these patients to effectively manage complications post pump placement.

The hepatic arterial infusion therapy is a treatment approach used for liver metastases in combination with surgical resection. This method of therapy delivers chemotherapy directly to the liver on a continuous basis via a surgically implanted pump. The nurse instructs the patient that a flow scan is necessary to assure proper pump function. Studies have shown that there was a significant decrease in liver cancer recurrence, and a trend toward an improved five-year overall survivor rate with HAI therapy. The nurse needs to understand the procedure, treatment, and complications associated with the HAI therapy to enhance the management of this complex patient population.

The inpatient nurses role on this hepatobiliary/gastrointestinal medicine unit specializes in the management of patients receiving HAI therapy, focusing on preventing complications and maintaining safety through patient education. Patient education is facilitated through written and verbal instructions. In the immediate postoperative period, the nurse assesses for pump pocket hematoma, seroma, infection, and inflammation, as well as pump pocket erosion and wound dehiscence.

The pump flow rate will vary depending on factors such as body temperature, altitude, arterial pressure at the catheter tip, and solution viscosity. Therefore, the nurses instruct the patients to avoid any heating equipment since they may cause a rise in the patient’s body temperature altering the flow rate. Patients are instructed to keep scheduled appointments for the pump’s drug chamber to be filled every fourteen days.

Patient education is imperative before HAI patients are discharged home from the inpatient setting. Inpatient nurses provide patients with the information they need to ensure that safety measures will be implemented. This presentation will provide an overview of the nursing care of patients with HAI through effective postoperative assessment, potential side effects, and patient education.