Congress Abstracts 2006

104

IMPROVING CARE OF THE HEAD AND NECK CANCER PATIENT RECEIVING COMBINATION CHEMOTHERAPY AND RADIATION THERAPY. Gail Funk, RN, OCN^®, and Tracy Gosselin-Acomb, RN, MSN, AOCN^®, Duke University Hospital System, Durham, NC.

Patients undergoing combination therapy for head and neck cancer face a variety of side effects that cause significant morbidity and affect treatment outcome. Many of these side effects are also the initial presenting symptoms of the disease including odynophagia, pain and weight loss. Effective assessment, education and symptom management are critical components of the nursing role in radiation oncology.

Patients undergoing combination treatment for head and neck cancer often experience candida, mucositis, nausea, odynophagia, pain, skin reaction, trismus, and xerostomia. These side effects impact the patient's nutritional status and early intervention is critical. The development of a comprehensive program to meet patient care needs by the primary nurse is essential to patient compliance during treatment and in the early follow-up phase.

The primary nurse in radiation oncology works collaboratively with the physician, physician assistant, dietitian and other support staff. The nurse provides continuity of care and serves as the patient advocate throughout treatment. The nurse completes daily assessments and uses a variety of educational tools to support the patient. The development of a daily calendar that includes information on prescriptive medications, nutrition needs, and oral care has also assisted patients in performing self-care. Patients may also receive supportive care medications and intravenous fluids as needed in the clinic. Patients who are on a clinical trial also benefit from this care.

Patients who receive timely assessment, intervention, and education are more compliant with treatment recommendations and typically do not require admission into the hospital. By having a primary nurse as part of the treatment team who understands the physiologic and psychosocial impact of treatment the quality of care and the desired outcomes can be achieved.

The model of primary nursing although not new is a viable way to provide patient care in an ambulatory setting. This model allows the nurse to work collaboratively with other healthcare providers and to develop appropriate resources to support care. Ultimately, it provides the patient with a consistent point of contact.