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- Title
NEUTROPENIA MANAGEMENT: USE OF A JOURNAL CLUB TO FORMAT CHANGE.
- Authors
O'Leary, Colleen; Gobel, Barbara Holmes; Vancura, Lesley
- Abstract
An evidence based neutropenia journal club was initiated to review current evidence regarding our institutional neutropenia management policies and procedures. The current precautions seemed overly restrictive for many patients, resulting in lower patient satisfaction and nurses questioning the restrictions. Three areas of care were identified to review: neutropenic diets, restriction of flowers, plants and balloons, and the use of masks by patients while out of their room. Journal articles from 1994 to 2004 were reviewed. Major gaps were identified as existing in evidence regarding nursing interventions in preventing and controlling infections in neutropenic patients. The role of diet in the development of infection in neutropenic patients was unclear. The review found little evidence for the restriction of plants, flowers, and balloons. There was no evidence that a neutropenic patient needed to wear a mask while out of their rooms as long as they remained on the unit that was hepa filtered. Practice changes were purposed to the existing neutropenic precautions policy based on current published evidence. These changes also correlate with the latest ONS Putting Evidence into Practice (PEP) guidelines. The changes included discontinuing the use of a neutropenic diets, allowing fresh flowers and plants as well as balloons for non-neutropenic patients (excluding the stem cell transplant unit), allowing silk flowers for neutropenic patients and discontinuation of masks for patients remaining on the unit. In order to make these practice changes, the proposals were taken through the nursing governance structure, patient care committee and medical executive committee. The outcome was that the neutropenic diet was discontinued with specific restrictions, patients would not be required to wear masks while on the unit, and silk flowers and balloons would be allowed in patient rooms. There has not been any increase in the number of negative events related to neutropenia. Patient satisfaction scores will be reviewed to verify an increase in satisfaction. Nurses involved in the process feel empowered to advocate for their patients based on evidence. Allowing nurses to identify nursing sensitive patient issues and giving them to the tools necessary to make change empowers them to provide the best possible care.
- Subjects
NEUTROPENIA; MEDICAL publishing; PATIENT satisfaction; NURSING practice; EVALUATION of medical care; NURSES
- Publication
Oncology Nursing Forum, 2007, Vol 34, Issue 2, p538
- ISSN
0190-535X
- Publication type
Article