Congress Abstracts 2005

28

UNITING ONCOLOGY NURSES TO DECREASE VARIABILITY IN AMIFOSTINE ADMINISTRATION. Annette Quinn, MSN, RN, University of Pittsburgh Cancer Centers, Pittsburgh, PA; Carrie Daly, RN, MS, AOCN^®, St. Josephs Hospital, Chicago, IL; and Tracy Gosselin, RN, MSN, AOCN^®, Duke University Medical Center, Durham, NC.

Amifostine is used to minimize treatment-related toxicity without reducing anti-tumor efficacy of chemotherapy or radiotherapy. Reduction of xerostomia in patients receiving amifostine is well-documented in the literature, and studies are on-going showing benefit in mucositis protection. The nurse’s role in the administration of this drug is critical as side effects include hypotension, nausea, vomiting, cutaneous and allergic reactions. These can be minimized by daily assessment assuring proper hydration, timing of antiemetics, administration techniques and mucosal and skin assessment.

Due to variability regarding administration and symptom management, it was felt that amifostine guidelines would help create uniformity in practice, allowing for best patient care. The purpose was to assemble medical and radiation oncology nurses to develop guidelines focusing on amifostine administration and symptom management, and to evaluate the dissemination and efficacy of the guidelines as related to standardization of administration protocols, minimizing side effects and homogeneity of dosage and administration in clinical trials.

Fifteen nurses throughout the United States, developed guidelines for the administration of amifostine and recommendations for managing the most common side effects associated with the drug. The guidelines focus on both intravenous and subcutaneous administration and provide the staff with a convenient method for ensuring safe administration and decreasing toxicity from amifostine. Most frequently asked questions have been addressed in a pamphlet and materials have also been developed for patient education, documentation and assessment of these patients.

In 2003 this group of 15 nurses interacted with 5,190 physicians, nurses, pharmacists and other healthcare professionals. As of July 31, 2004 the 15 nurses have interacted with 4,699 health care professionals. In addition, 50 CEU programs with 541 attendees have also been accomplished. Clinical conferencing, on-site visits, and record keeping of calls received from clinicians have allowed for evaluation and success of the guidelines.

The guidelines which have been disseminated by the nurses in peer to peer interactions have decreased the variability in amifostine administration thus reducing the side effects and making evaluation of clinical trial results much more reliable. Nurses should refer to the guidelines when administering amifostine in the clinical setting to help diminish treatment related toxicity.

Vested interest: The primary author is an independent contractor for Oncology Education Services, Inc., in a program sponsored by MedImmune