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Congress Abstracts 2006
47
PERFORMANCE IMPROVEMENT: FATIGUE INTERVENTION PROJECT. Sandy Balentine, RN, OCN®, Mary Dinos, RN, OCN®, Maureen Flannery, LSW, and Fran Cartwright, RN, PhD, AOCN®, Valley Hospital, Paramus, NJ; Bette Williams, RN, Valley Hospital, Ridgewood, NJ; and Linda Ohnikian, RN, Valley Hospital, Paramus, NJ.
Fatigue remains a common and distressing symptom in individuals with cancer. ONS recommends that all patients with cancer should be assessed for fatigue and receive fatigue education and management.
The Performance Improvement Cancer Committee (PICC) identified the need to standardize the assessment and management of fatigue in inpatient oncology, radiation oncology and the ambulatory infusion center. A fatigue management packet was developed based on a literature review. The information packet is consistent with the interventions listed on the ONS "Evidence that nursing interventions influence fatigue".
The 0 to 10 fatigue scale was entered into the plan of care in inpatient oncology, radiation oncology and the ambulatory infusion center. Patients are assessed at the start of treatment, at defined intervals, and when patients complain of fatigue. All patients are given the fatigue management packet. Consistent with the NCCN guidelines (2005) and OCN® (2006 - 2009), patients who score 4 or greater on the 0 -10 scale (moderate to severe fatigue) are referred to a fatigue counselor for a more comprehensive assessment.
Data for the first month of the fatigue intervention project was reported at the PICC. Although it is a small sample, the data suggests that there are significant differences across diagnoses and treatment regimens. This will remain on the PICC agenda. Data will be examined to identify patients response to the intervention packet and counseling. Revisions to the project will be made. Topics for research will be explored based on this outcome data.
The oncology nurse is in a pivotal position to measure fatigue and to provide information about fatigue management that can influence severity of fatigue and/or the distress experienced form this troubling symptom.