Background: Breast cancer care is delivered by multiple providers over an extended period of time within an already fragmented healthcare system, which has led to gaps in the care process. [ Read More ]
August 2012 VOL 3, NO 4
Say Ahh! Making Sense of Oral Assessments for Mucositis
Joanne Growney, RN, ANP-BC, MA, OCN
Background: Mucositis occurs in 15% to 40% of patients receiving chemotherapy or radiation therapy for cancer treatments.1 Patients and caregivers have dissatisfaction with the cancer treatment side effect of mucositis. Also, it has been shown that patients and caregivers are unaware of how to perform oral assessments and oral hygiene. Gaps in the literature suggest there is an inconsistency with oral assessments for mucositis, thus limiting the strength of the study findings and suggesting more research is needed to validate intervention outcome effectiveness.
Objective: To develop a standardized patient education booklet for the identification of signs and symptoms of mucositis and of oral hygiene practices in cancer populations.
Methods: This evidence-based practice (EBP) project will utilize the Johns Hopkins model for EBP methodology. Retrospective chart reviews will be conducted to identify the number of times education has been provided to the patient for signs and symptoms of mucositis and oral hygiene practices. An education plan will be developed to teach patients how to assess the mouth for mucositis and how to perform oral hygiene. The nurse navigator will be utilized to perform follow-up care and guide the patient along the care continuum including the survivorship phase. Subsequent chart reviews will be conducted to evaluate the outcomes.
Results: The outcome of this project will be the development of a standard approach for clinical assessments by the nurse navigator for mucositis, and patient education for oral self-examinations and oral hygiene to recognize and limit the effects of mucositis through earlier recognition across cancer populations. The current data from the pilot support the use of a standardized oral assessment tool that will be used to drive the nurse navigator assessments to manage patient symptoms of mucositis. In addition, patient education is being standardized for oral hygiene.
Conclusions: Patients and caregivers will be able to demonstrate and articulate an oral assessment, signs and symptoms of mucositis, and oral hygiene practices. The nurse navigator role is intended to enhance cancer care for symptom management so that these assessment skills and oral hygiene practices will become part of the nurse navigator armament to aid the patient through the treatment process.
Cawley MM, Benson LM. Current trends in managing oral mucositis. Clin J Oncol Nurs. 2005;9(5):584-591.
Background: Patient navigation (PN) in cancer care refers to the individualized care provided to the breast cancer patients, families, and caregivers to ease multiple barriers and facilitate timely access to [ Read More ]