Oncology Nursing Society 32nd Annual Congress Podium and Poster Abstracts
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Oncology Nursing Forum
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PLEURX CATHETERS VERSUS TRADITIONAL CHEST TUBES FOR
MALIGNANT PLEURAL EFFUSION: AN OUTCOMES MEASUREMENT.
Marie Swisher, MSN, RN, OCN
, Sidney Kimmel Cancer Center at
Johns Hopkins Comprehensive Cancer Center, Baltimore, MD; and
Emily Marshall, BSN, RN, Sidney Kimmel Comprehensive Cancer
Center at Johns Hopkins Hospital, Baltimore, MD.
The use of PleurX™ Pleural catheter, a long term indwelling cath-
eter for management of recurrent malignant pleural effusions (MPE)
was recently introduced in this NCI designated Comprehensive Can-
cer Center. Treatment of MPE was managed in the past by chest tube
(CHT) insertion and drainage often using video assisted thorascopy
(VAT) and mechanical and/or chemical pleurodesis, with varying
success rates. At our institution, CHT placement involved an admis-
sion to the hospital, average length of stay (LOS) of 6.5 days, at an
average hospital cost (HC) of $41,000. In addition, patients experi-
enced pain often requiring patient controlled analgesics (PCA). The
introduction of the PleurX™, which in previous studies allowed for
outpatient management, has offered another option in the manage-
ment of MPE for cancer patients. Previous studies have shown that
these catheters are effective at relieving dyspnea, decreasing HCs,
and reducing signiﬁcant discomfort experienced by patients primar-
ily related to a smaller, more ﬂexible PleurX™.
The purpose of this presentation is to describe this Cancer Center’s
experience using the PleurX™ during the ﬁrst 12 months of imple-
mentation. This will include outcome measurements of LOS, HCs,
pain and use of analgesics, complications, and home management is-
sues in this group of patients’ compared to patients who had received
traditional CHT management.
An outcomes database was developed with approval of the Insti-
tution’s Internal Review Board (IRB). Outcome measures from an
equal group of patients managed with CHT and PleurX™ were com-
pared. A case scenario approach will be utilized to provide a review
of a typical patient’s PleurX™ treatment course.
An analysis of the outcomes measurements will be completed. Based
on these results, nursing recommendations will be developed and in-
cluded in patient & family and staff education about this new therapy.
As members of the multidisciplinary team, oncology nurses are in
a unique position to study the impact of new treatment modalities on
patients and associated nursing care. This review can help to quickly
adapt new teaching materials, not only for patients and their families,
but also for staff. Development of an ongoing database will allow for
continued monitoring of the effectiveness of this new technology.
cology nurses interface with basic scientists, physicians and comput-
er programmers to identify datapoints to be collected, their impor-
tance to disease initiation and clinical outcome, to work in building
the program and then test it.
As community hospitals become hybrids of private practice and hos-
pital-based physicians, data collection for research is difﬁcult. Nurs-
ing is the commonality of all settings and centralizes data collection
between practices and the hospital itself. Whether ﬁnding an existing
program that will answer needs or building one, a multi-disciplinary
team is needed to get the right one and nursing is a key member.
The nursing representative was identiﬁed by the multi-disciplin-
ary team as the immediate contact and “go-to” person for questions
and testing of models. All information to be collected was discussed
between clinicians, basic scientists and the nurse and then formatted
into spreadsheets for use by the computer programmers. As the sys-
tem became functional, the nurse populated the system with practice
patients to test the system for: ease of data input, availability of data
in routine MD charting and querying the data for missing datapoints
and expected research questions.
Oncology clinical research requires specialized knowledge to un-
derstand the unique patient populations and the many endpoints that
can be used to evaluate cancer treatments. The Clinical Cancer Ana-
lytic Research Database (CCARD) was developed to collect data on
6 disease sites, with a focus on the data being information needed to
answer potential questions for combined investigator-initiated basic
science and clinical research. Additional sites will be added as time
and needs arise.
As community hospitals grow, many begin to adopt an academic
model, which includes investigator-initiated research. Building re-
search programming that responds to the needs of basic scientists
and clinical physicians needs a point person who has knowledge that
bridges the knowledge realms of computer programmers and cancer
specialists. The oncology nurse ﬁts that role best, as someone who
can speak to clinical issues in lay-person terms.
DEVELOPMENT OF A HOSPITAL-BASED CLINICAL RESEARCH DATA-
BASE. Rosemarie Tucci, RN, MSN, AOCN
, Lankenau Hospital, Wyn-
Investigator-initiated oncology research in a community hospital
requires data collection best completed with nursing oversight. On-
LDI: THAT’S ONE SMALL STEP FOR A NURSE, ONE GIANT LEAP FOR
A CANCER CENTER. Camille Servodidio, RN, MPH, CRNO, OCN
CCRP, Hartford Hospital, Hartford, CT.
Leadership Development Institute (LDI) provided the opportunity,
motivation, and the skill set for one nurse fellow to work with cancer
nursing colleagues on a yearlong project.
The purpose of the LDI project was to develop and implement a
rewards and recognition program for certiﬁed oncology nurses in a
community hospital’s cancer center. No formal certiﬁcation recogni-
tion program was in place. Implementing a change in hospital setting
can parallel the landing on the moon.
A needs assessment survey was developed and distributed to 50
nurses in the cancer program. 19 (38%) of the surveys were returned.
Cancer program nurses identiﬁed plaques and pins as two of the pre-
ONCOLOGY NURSING FORUM – VOL 34, NO 2, 2007