Congress Abstracts 2005

81

THE AMBULATORY NURSE: A VITAL ASSET TO PATIENTS TAKING INTERFERON. Anne Valentini, RN, BSN, and Patricia Fischer, MSN, Memorial Sloan-Kettering Cancer Center, New York, NY.

With the ever-growing shift in treatment to an outpatient setting, the ambulatory nurse plays a vital role in educating patients to ensure their safety at home. Interferon, a cytokine used to treat metastatic kidney cancer, is administered subcutaneously and is associated with numerous toxicities. The nurse is an integral part of the healthcare team educating patients about administration techniques, management of debilitating side effects, and self care measures to enhance quality of life.

At this NCI designated cancer center, the nurse educates patients about self-subcutaneous administration of interferon using a multidose pen. The pen makes it safer for patients taking this medication at home by eliminating many steps of a conventional injection, therefore decreasing chance of complications related to contamination and/or error. Nurses managing these patients need clinical expertise about the disease and competency using the multidose pen. In order to meet the needs of staff and patients, a program was developed to ensure competency of nurses about correct usage of the pen and the development of a nursing care plan.

A staff nurse with expertise on this subject organized an inservice that incorporated an overview of kidney cancer, treatment with interferon, hands-on demonstration of the pen, and management of side effects. A take-home teaching packet was devised that included step by step instructions for use of the pen, fact card about interferon, instructions on home disposal of needles, and booklet on subcutaneous injections. This inservice not only educated nurses, but served as a forum for discussion of patient issues and nursing concerns related to self-administration of interferon.

The nurses verbalized increased confidence and decreased anxiety about this subject after attending the inservice. Patients stated that they used the teaching packets as a constant source of referral. Patient safety was enhanced through the use of verbal, printed, and hands-on instruction.

It is crucial that nurses develop expertise and explore ways to improve home safety to assure safe self-administration of medications at home. This presentation will provide information for developing an inservice and patient instructional packet that nurses can use in their setting to educate peers and patients.