Congress Abstracts 2006

317

IS NAUSEA AND VOMITING STILL A PROBLEM FOR HIGH-DOSE THERAPY PATIENTS? USING EVIDENCE TO GUIDE OUR CARE. Morgin Dunleavy, RN, BSN, Janelle Wood, RN, BSN, June Eilers, PhD, RN, BC, CS, and Nikki Miller, PharmD, Nebraska Medical Center, Omaha, NE.

Chemotherapy induced nausea and vomiting (CINV) is a significant problem for patients, families, and caregivers in oncology. Studies indicate that discrepancies exist between the professional perception and the patient's experience of CINV. Understanding the mechanisms behind nausea and vomiting and the treatment options available is important in order to anticipate patient needs and provide better symptom management, thus improving patient outcomes. Although there has been extensive research in the area of CINV, evidence regarding the best approach for multi-day, high-dose therapies remains limited.

The purpose of this project was to address CINV for patients receiving multi-day, high- dose chemotherapy treatments and to establish a standardized approach for assessment and management in our patients.

This project was guided by the National Comprehensive Cancer Network and Multinational Association for Supportive Care in Cancer clinical practice guidelines. The Hesketh emetogenic potential guidelines were used to determine the likelihood of CINV on each treatment day. Through patient and nurse interviews we have been able to track the prevalence of nausea and vomiting throughout the different protocols and treatment days and determine discrepancies between nurse and patient perception of CINV. We have focused on improved documentation of nausea and vomiting using a 0-10 scale and have compared nurse and patient perceptions of the management of CINV. Education was provided to nursing staff and patients on the differences between nausea and vomiting, including acute versus delayed, and the mechanisms involved.

Data collected showed we have better symptom management with acute nausea and vomiting, but need to continue to address control of the delayed nausea and vomiting experienced by many of our high-dose therapy patients.