Congress Abstracts 2006

42

PREVENTION AS INTERVENTION: DEVELOPMENT OF EVIDENCE BASED LYMPHEDEMA RISK ASSESSMENT TOOL AND PRACTICE GUIDELINES. Kimberly Willis, RN, BSN, and Marybeth Singer, MS, APRN-BC, AOCN^®, Tufts-New England Medical Center, Boston, MA.

The American Cancer Society estimates that more that 211,000 women and 1690 men will be diagnosed with breast cancer in 2005. Relative survival at five years for those with localized disease is 98%(ACS, 2005). Lymph node staging is an essential component of treatment. Despite recent advances in surgical techniques, lymphedema continues to pose a threat to quality of survival for persons with breast cancer. It is estimated that between 10-60% of all breast cancer survivors experience lymphedema. Oncology nurses play a key role in identifying patients at risk and providing necessary education and preventative strategies in order to minimize complications of lymphedema and to improve the quality of life for those suffering from the affects of lymphedema.

Utilizing a thorough review of the literature to date, we developed a risk assessment tool to stratify risk of development of lymphedema. Practice Guidelines were developed and standard teaching plan developed for implementation at our institution

We pilot tested the use of our Lymphedema Risk Assessment Tool and implemented standardized teaching plan for those patients receiving chemotherapy in our infusion center for breast cancer.

Upon completion of above, we elicited feedback from staff and patients regarding their understanding of lymphedema, knowledge of steps to take for signs and symptoms of infection/lymphangitis and preventative measures to avoid injury or overuse of affected limb. Lymphedema is an often overlooked complication of breast cancer treatment and oncology nurses play a key role in partnering with patients in utilization of prevention as intervention.

Oncology nurses, particularly those in advanced practice, play a significant role in educating patients regarding self care and monitoring to prevent and detect early signs of complications related to lymphedema. Utilizing the tools developed by this project and the evidence-based guidelines will improve identification of patients at risk and improve quality of live and reduce risk of complications of lymphedema.