Clostridioides Difficile Colonization and Infection in Patients With Cancer
Infection with Clostridioides difficile (commonly referred to as C. diff; formerly Clostridium difficile) is an extreme example of a type of gut microbiome dysbiosis that can occur in patients with cancer. C. diff is a gram-positive, anaerobic, spore-forming, toxigenic bacterium, and infection is acquired via fecal-oral transmission and can cause symptoms ranging from uncomplicated diarrhea to pseudomembranous colitis and toxic megacolon. Because of many common risk factors (e.g., use of antibiotic therapy, advanced age, exposure to healthcare environments, immunosuppression), the hematology and oncology population is at high risk for C. diff colonization or infection.
Cancer and the Gut
Our gut microbiome—the diverse community of microorganisms, including bacteria, archaea, viruses, and eukaryotes such as fungi, that inhabit the gastrointestinal (GI) tract—can affect our entire body’s health. Most people’s microbiomes have a healthy balance of organisms that stay contained in the GI tract because of the lining’s tight epithelial cell junctions. But from the gut, bacteria are capable of generating a range of vitamins, synthesizing amino acids, and breaking down and metabolizing indigestible carbohydrates. And a growing body of evidence—including studies conducted by oncology nurse scientists—is uncovering how the gut microbiome can influence a patient’s response to cancer treatment and their overall outcomes.
Real-World Usage Reports Show That ONS Guidelines™ Empower Nurses to Provide Best Patient Care
Among their many benefits in practice, ONS Guidelines™ arm oncology nurses with the evidence to advocate for their patients’ care, according to findings from a fall 2021 focus group ONS conducted with nurses practicing at all levels of direct care.
From Evidence to Standard: The Role of Clinical Guidelines in Oncology Care
Leading organizations like ONS develop nationally recommended, evidence-based cancer care guidelines to inform practice, unify and standardize the way patient care is delivered, and ensure successful outcomes. By clarifying gray areas and codifying practice, guidelines enable providers to deliver efficacious, safe oncology care for patients and all care providers.
Use the Evidence to Support Physical Activity During and After Cancer Treatment
We’re familiar with the evidence: being active is better for all of us throughout our lives. In fact, regular physical activity is one of the most important things we can do for our health, according to the Centers for Disease Control and Prevention. Physical activity can help to control our weight and reduce our risk of cardiovascular disease, type 2 diabetes, and some cancers.
AHRQ Shutters National Guideline Clearinghouse Because of Budget Cuts
As of July 16, 2018, the Agency for Healthcare Research and Quality (AHRQ) through the U.S. Department of Health and Human Services ceased maintenance on guideline.gov, the website that housed the National Guideline Clearinghouse. The website had been a resource for healthcare providers for more than 20 years.
Overcome Barriers to Applying an Evidence-Based Process for Practice Change
The evidence-based practice (EBP) process starts with a clinical question and then proceeds to searching and critically appraising the evidence. Once you have determined that a practice change is necessary, the next step is to integrate that evidence with clinical expertise and patient preferences and values. The last step in EBP is to evaluate the outcomes and disseminate the results. On paper, this flows in an orderly fashion. As clinicians, however, we know that it’s not often that easy or straightforward to change clinical practice. We often face barriers that can make it hard to change, but strategies exist to help facilitate practice change.
Put Evidence Into Practice to Prevent Infection
Because of immunosuppression from cancer or its treatment, patients are at a higher risk for viral, bacterial, and fungal infections. Patients who develop infections may experience dose delays or reductions that compromise optimal treatment outcomes, resulting in higher mortality rates, longer hospitalizations, and higher cost of care.
Managing Weight Loss in Patients With Cancer
Patients’ weight and nutrition status will often vary throughout the cancer care continuum. Weight loss might occur before the diagnosis, be one of the presenting cancer symptoms, be related to the tumor itself, or be secondary to side effects of their treatment (e.g., anorexia from chemotherapy or radiation).
Adopt an Evidence-Based Practice Model to Facilitate Practice Change
Evidence-based practice (EBP) results from the integration of available research, clinical expertise, and patient preferences to individualize care and promote effective care decision-making. Oncology nurses are perfectly positioned to be adopters and promoters of EBP, resulting in practice change for improved quality and safety.
Assess and Manage Cancer-Related Pain
Despite the findings that more than 90% of cancer pain can be controlled with routine interventions, many patients continue to experience pain throughout their cancer diagnosis and treatment. The average pain score for patients on inpatient oncology units is 5.87 on a 0–10 scale, and 25% of patients spend more than 50% of the time in constant or severe pain.
Manage Pain in Patients With Cancer With These Tools and Resources
One distinct, uniquely personal symptom unifies almost all patients with cancer: pain. It can be as wildly varied and different as each patient it affects. It can be acute, sudden experiences of pain, or the symptoms can be chronic and perpetual. Patients undergoing the treatments associated with cancer often suffer varying degrees of pain through their cancer journeys, which leads to significant physical and psychosocial burdens. This can decrease their quality of life and potentially impact their overall outcomes. A 2015 National Comprehensive Cancer Network report suggested that the evidence suggests a clear link between improved survival outcomes and adequate symptom management.
Physical Activity Benefits Patients and Nurses Throughout Life
My husband is a gerontologist. My oldest daughter is an RN working with acutely ill elderly patients at a busy academic medical center. They both know that living to 90 or 100 years old is becoming the norm. They’ll also tell you that the habits formed throughout a lifetime can make a big difference in the quality of life as one gets older.
Physical Activity, Psychological Care Reduce Cancer-Related Fatigue
Physical activity, by itself or in combination with psychological care, was found to be most successful at reducing cancer-related fatigue (CRF) in patients, according to a study published in JAMA. The researchers compared the efficacy of four different types of CRF treatments—exercise, the combination of exercise and psychological treatments, psychological treatments alone, and pharmaceutical treatments—to determine the most effective treatment for CRF.