The Case of the GVHD Double-Take
Jeff is a 60-year-old patient with myeloproliferative disease. After his care team secured a 9/10 match, he received an allogeneic hematopoietic stem cell transplantation with a conditioning regimen of fludarabine and melphalan. Neutrophil engraftment occurred at day 20, and he was discharged to home shortly after engraftment. One month later, he presented to the clinic with abdominal pain and a new diffuse erythematous rash, which his care team initially treated with corticosteroids. However, his abdominal pain persisted, and Jeff was admitted to the hospital a few days later for further workup for suspected acute graft-versus-host disease (GVHD). A computed tomography scan of his abdomen demonstrated worsening enterocolitis because of Yersinia enterocolitica. What would you do?
Maximize Your Words’ Healing Power
Effectively treating a cancer diagnosis requires an immense amount of collaboration. Clinicians are equipped with the clinical knowledge to provide the best care possible, and sharing that crucial information with each other and patients is essential for optimal patient outcomes.
Radiation Oncology Nurses Must Innovate and Transform in Today’s Workplace
In a highly technical environment, radiation oncology nurses’ role on the interprofessional team is both critical and flourishing. But it’s also ever-evolving, speakers explained during a session on April 27, 2021, for the 46th Annual ONS Congress™.
What Is the Role of Genetic Counselors in Cancer Care?
Our understanding of cancer’s genetic components is constantly growing, with new cancer susceptibility genes discovered every year that change how we screen for and treat cancer. Genetics specialists keep up with the latest information and implications of genetic results is and can be a great addition to comprehensive oncology teams.
Advanced Practice Nurses Are at the Heart of Patient Care in Cardio-Oncology
Cardiovascular disease and cancer, the two leading causes of mortality worldwide, share risk factors that have a direct impact on patient care and survival. During a session for the inaugural ONS Bridge™ virtual conference, Anecita P. Fadol, PhD, APRN, FAANP, FAAN, of the University of Texas MD Anderson Cancer Center, discussed what advanced practice nurses need to know about the evolving specialty of cardio-oncology to improve patient outcomes.
What Oncology Nurses Should Know About Medical Physicists in Radiation Oncology
As many as 50% of patients with cancer receive treatment with radiation therapy with the goal of cure or reducing pain and other symptoms. During a presentation at the inaugural ONS Bridge™ virtual conference, Sotiri Stathakis, PhD, DABR, offered nurses insights into the field from the perspective of a medical physicist.
How Can Oncology Nurses Collaborate With Dietitians to Manage Malnutrition?
Nutrition impact symptoms (NIS) involve any barrier to a patient’s nutritional status. Cancer and its treatments often lead to complex side effects that develop rapidly and change in character and intensity throughout treatment. Barriers to eating and drinking, digesting, and absorbing nutrients lead to negative clinical outcomes for patients with cancer, including malnutrition. Prompt assessment and interventions are key to helping patients avoid treatment holidays and dose reductions while also promoting the best possible quality of life during their cancer journey. In fact, a weight loss of just 5% is an indicator that a patient will likely not receive all of his or her prescribed cancer treatment.
USP <800> Brings Change, Collaboration to Pharmacy and Nursing
U.S. Pharmacopeia (USP) chapter <800> provides safety measures for all healthcare workers in any setting where hazardous drugs (HDs) are used in the health system. For situations from the initial delivery of the drug to the institution through administration and disposal, USP <800> provides a vast number of safety measures intended to minimize risk and potential exposure to HDs. To meet the new requirements, medical institutions and pharmacies have had to make significant changes in various systems.
Collaboration Is Key to CAR T-Cell Therapy Management Across Settings
As of February 2019, only 160 institutions across the United States are certified to administer CAR T-cell therapy, meaning many eligible patients may need to be referred to a treatment center outside of the local ambulatory or community cancer center where they had previously received treatment. The transition from primary oncologist to certified center and back again requires careful coordination to ensure important steps and information aren’t lost.
Interprofessional Collaboration Is Essential for Optimal Chemoradiation Outcomes
Navigating patients through radiation treatments can be challenging when they are undergoing concurrent therapy. Coordination of multiple providers across different specialties, side effect management, and scheduling can be overwhelming. During a session at the ONS 44th Annual Congress in Anaheim, CA, Dorothy Abshire, BSN, BA, RN, OCN®, of Baylor Scott and White McClinton Cancer Center, Waco, TX, explained how oncology nurses can help patients navigate complicated treatment regimens that involve both chemotherapy and radiation therapies.
What Is the Role of Interprofessional Teams in a BMT Unit?
The old saying, “it takes a village,” comes to mind. Many team members are needed to help a patient through one of the most critical times of their lives. Blood and marrow transplant (BMT) nurses play a large role, along with BMT physicians. However, we also depend on our BMT pharmacist, BMT dietician, and BMT social worker as part of the interprofessional team. Our patients not only need excellent nursing and medical care, but they also need care from members of the team to support them physically, psychologically, and nutritionally from transplant prep through the transplant itself and into the recovery phase.
Interprofessional Collaborations Improve Cancer Care
When faced with a difficult problem, it’s human nature to seek different perspectives, to work together with others facing similar issues to accomplish a common goal. Compromise, collaboration, and communication are essential to successful teams—whether it’s your daughter’s basketball team, the U.S. government, or any group in between. In oncology, teamwork is no different. Bringing together professionals from different disciplines can yield tremendous results for patients with cancer.
Involve the Palliative Care Team Early to Minimize Symptom Impact
Patients with cancer experience many feelings: they’re frightened and they’re hopeful, but mostly they’re in a new world. Symptoms associated with cancer and its treatment are taxing on patients’ physical, emotional, and spiritual well-being. In some cases, cancer-related symptoms and side effects are so debilitating that providers struggle to manage them just to get patients to a point where they can continue their treatment. Oncology nurses can lead the interprofessional care team to work together to proactively manage symptoms to ensure patients can endure treatment and come out as themselves on the other side. Proper symptom management doesn’t just promote quality of life but the best possible chance for patient survival.
How Can Oncology and ICU Nurses Work Together to Treat Critically Ill Patients With Cancer?
Nurses in the intensive care unit (ICU) generally see patients with cancer only when they are extremely sick—not throughout the extensive cancer journey they go through before they get to the ICU. Educating and familiarizing ourselves, as ICU nurses, with a patient’s oncology plan, goals, and history can improve overall care. Learning at which points in the process of cancer treatment certain issues are more likely to arise, such as tumor lysis syndrome during high-dose induction, when a patient is most likely to be neutropenic during a stem cell transplant, and other general facts about oncology, can help improve the care we give. It helps us understand our patients as a whole. The oncology population is a huge part of medical intensive care, and encouraging critical care nurses and oncology nurses to collaborate can help improve the continuity of care and eliminate errors in the ICU.
Critical Care for Patients With Cancer
Five to Ten Percent of patients with cancer will need to visit the intensive care unit (ICU) for a life-threatening condition. In fact, estimates suggest that nearly 30% of patients with esophageal cancer or acute leukemia and those undergoing allogenic stem cell transplantation will need ICU care.
Leadership Strategies for Nursing Excellence
The triple aim of healthcare is patient satisfaction, quality outcomes, and decreased costs. Navigation is the key to effective care delivery, said Regina Cunningham, PhD, RN, NEA-BC, FAAN, chief executive officer of the Hospital of the University of Pennsylvania, during the Endnote Session at the Oncology Nurse Advisor Navigation Summit.
Handoff Tool Promotes Nurse-to-Nurse Communication to Avoid Patient Adverse Events
RuthAnn Gordon, MSN,FNP-BC, OCN®, from Memorial Sloan-Kettering Cancer Center in New York, and co-authors presented the findings during a poster session at the ONS 42nd Annual Congress in Denver, CO. The poster was titled “Utilizing Nurse to Nurse Handoff Communication to Manage Immune Related Adverse Events in an Outpatient Immunotherapy Clinic.”
Improved Nurse and Pharmacist Communications Optimizes the Medication Use Process
Judy Ranous, BSN, RN, OCN®, from the Froedtert Hospital in Wisconsin, and coauthors presented their poster entitled “Design and Implementation of an Oncology and Pharmacy Nursing Committee to Optimize Interdisciplinary Communication and Patient Safety” at the 42nd Annual ONS Congress in Denver, CO.
The Impact of Comorbidities on Patient Care
More than ever before, oncology nurses are required to provide multifaceted care when it comes to managing patients with cancer. As the population of patients with cancer continues to age and cancer becomes more of a chronic condition, oncology nurses are seeing more patients who exhibit comorbidities during their cancer journey.