PSJMCOncology

  Perceived Quality of Work Life and Risk for Compassion Fatigue Among Oncology Nurses: A Mixed-Methods Study  Ellen Giarelli, EdD, RN, CRNP, Jami Denigris, BSN, OCN®, Kathleen Fisher, PhD,  MaryKay Maley, DNP, APN, and Elizabeth Nola   Purpose/Objectives: To examine factors that influenced the nurse’s perceived quality  of work life and risk for compassion fatigue (CF). The specific aims of the study were to  describe the (a) relationship among nurse characteristics and perceived quality of work  life, (b) relationship between personal life stress and perceived quality of work life, and  (c) the nurse’s beliefs about his or her risk for CF.   Research Approach : A descriptive, mixed-methods study.  Setting: A hematology-oncology unit in a large urban teaching hospital in Pennsylvania.  Participants: 20 oncology nurses.  Methodologic Approach: Descriptive study using questionnaires and in-depth interviews.  The variables ...

  Central  Line Care: Reducing  Central  Line–Associated Bloodstream Infections on a Hematologic Malignancy and Stem Cell Transplant Unit Background:  Patients with hematologic malignancies and stem cell transplant recipients are at increased risk for infections because of their prolonged periods of profound neutropenia. Central line–associated bloodstream infections (CLABSIs) can result in lengthy hospitalizations, increased healthcare costs, and increased morbidity and mortality. Objectives:  The aim of this comprehensive educational training program was to reduce CLABSI rates by focusing on the standardized practices associated with use, care, and maintenance of all types of central lines. Methods:  A pretest was administered to nursing staff. Based on the responses, an education program was then created. The program consisted of a comprehensive two-hour class using different modalities of teaching, including standardized practices associated with c...

  Chlorhexidine Gluconate Baths: Supporting Daily Use to Reduce Central Line–Associated Bloodstream Infections Affecting Immunocompromised Patients Background : Chlorhexidine gluconate (CHG) has a broad-spectrum antimicrobial property that has proven to be effective in prolonging skin antisepsis and decreasing pathogens often seen in oncology units. Objectives: The aim was to reduce the incidence of central line–associated bloodstream infections in a hematology-oncology unit through the staff’s continued adherence to the institution’s protocol for CHG baths with wipes, and to identify barriers and the degree to which they interfered with optimal use of the CHG wipes. Methods: The project focused on supporting staff and nurses by providing education and training on current practices to staff and patients, and identifying barriers. Direct observation and chart audits were the approach chosen to implement the project. Findings : For the project study period, the unit had three nonpre...

Central  Line Patency: Management With Normal Saline Flushes for Adult Patients With Cancer  Background:  Central venous catheter (CVC) maintenance is critical in administering chemotherapy, transfusions, and high-frequency laboratory draws. Although normal saline (NS) flushes have been associated with similar incidences of irreversible port occlusions as heparin among adult patients with cancer and ports, additional research is needed regarding NS efficacy in other central line maintenance within large populations with cancer. Objectives:  The aim of this study was to analyze changes in reported CVC line patency via tissue plasminogen activator (tPA) administration rates in ports and other central lines because of an institutional switch from heparin to NS as preferred flushes in adult ambulatory patients with cancer. Methods:  Retrospective data were collected from patients with ports (3,706 prepolicy, 3,402 postpolicy) and nonport CVCs (816 prepolicy, 694 pos...