By following guidelines for antiemetic regimens, chemotherapy-induced nausea and vomiting (CINV) can be prevented in most patients. Oncology nurses can be an important member of a multidisciplinary health care team to promote and reinforce those guidelines to achieve optimal patient care.
Oncology nurses were surveyed to assess awareness of antiemetic guidelines and gather information on current practice patterns and administration of antiemetics. Rebecca Clark-Snow, RN, BSN, OCN®, Cynthia N. Rittenberg, RN, MN, AOCN®, FAAN, and Mary L. Affronti, DNP, RN, MHSc, ANP, presented the survey findings during a poster session at the ONS 41st Annual Congress in San Antonio, TX. The poster was titled “Evaluation of Practice Patterns for Prevention of Chemotherapy-Induced Nausea and Vomiting (CINV) and Adherence to Antiemetic Guidelines: Results of a Survey of Oncology Nurses.”
ONS:Edge conducted the 21-question email survey in September 2015, inviting approximately 8,000 practicing U.S. oncology nurses to participate, of whom all were ONS members. The study was funded by Eisai Inc. Respondents were asked to rate their confidence in knowledge of emetogenicity of chemotherapy regimens and describe challenges and unmet needs in their practice.
A total of 531 nurses completed the survey. Most were full-time (n = 439; 99.8%) staff nurses (n = 390; 73.4%) who worked in the outpatient setting (n = 342; 64.4%) at a physician’s office or infusion center (n = 199; 37.5%).
Almost all of the respondents (97%) said they were at least “somewhat confident” in their knowledge of the emetogenic potential of various chemotherapy agents and regimens, and nurses in the outpatient setting had significantly greater confidence in their knowledge compared with those in the inpatient setting (75% versus 57%, respectively; p = 0.002). Nurses who had more years in the industry and more years as ONS members had greater confidence in their knowledge (p = 0.012 and p = 0.011, respectively).
The respondents were most familiar with (73%) and most often used (66%) the National Comprehensive Cancer Network antiemetic guidelines compared with the American Society of Clinical Oncology (48% and 34%, respectively) and internal institutional guidelines (31% for each).
The nurses reported that physician preference was the greatest barrier interfering with the use of guideline-recommended antiemetic prophylaxis (71%). Other responses included “satisfied with current antiemetics” (27%), “product insurance coverage” (26%), “product cost” (26%), and “medications not on formulary” (25%). Nurses reported that controlling delayed CINV was the greatest practice challenge (weighted rank score = 867).
Only 17% of respondents reported that more than 75% of patients had CINV under control, while most (38%) reported that 50%−75% of patients had controlled CINV.
“This survey highlights opportunities to increase nurses’ awareness of antiemetic guidelines to develop practical, multifaceted approaches for overcoming barriers interfering with antiemetic use within their practice and to ultimately improve CINV control and quality of life for patients undergoing emetogenic chemotherapy,” the authors concluded.
Clark-Snow, R., Rittenberg, C., & Affronti, L. (2016). Evaluation of practice patterns for prevention of chemotherapy-induced nausea and vomiting (CINV) and adherence to antiemetic guidelines: Results of a survey of oncology nurses. Poster presented at the ONS 41st Annual Congress, San Antonio, TX, April 28–May 1, 2016.