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Article # 11

  Using the Ipsilateral Arm in Patients With Breast Cancer: An Evidence-Based Practice Project and Practice Change   June 2025 • Volume 29, number 3, pages 212 - 218 • DOI: 10.1188/25.CJON.212-218   Kathryn L. Shady   Background: The ipsilateral arm is not used for blood pressure, phlebotomy, or IV access postmastectomy or post–lymph node removal or biopsy. The non–evidence-based practice of blanket forbidding of ipsilateral arm use can result in inaccurate calf blood pressure measurements, foot stick blood draw orders, and an increased need for tunneled central venous catheters.   Objectives: This project piloted a practice change and allowed for the use of the ipsilateral arm in patients with breast cancer.   Methods: The team used the Johns Hopkins Evidence-Based Practice Model to implement a practice change for hematology-oncology inpatients with breast cancer and lymph node involvement, removal, or biopsy, or mastectomy history.   Findings: T...
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 Article #10 Temperature Measurements Comparison of different thermometer types for patients with cancer     Deborah Gates, RN, BSN, MSN, Victoria Horner, PhD, BSc, BSN, RN, OCN®, Lindsey Bradle y, RN, OCN®, Takeya Fogle Sheperd, MSN, APRN, FNP-C, Omena John, RN, BSN, and Melinda Higgins, PhD     BACKGROUND : Accurate temperature measure ment  in patients with cancer  is  critical. Many patients are neutropenic; therefore, fever  represents  an oncologic emergency, and, in many cases, it can be the only  indication  of a life-threatening infection. Although oral thermometers most closely rep resent  true  core temperature, patients may have barriers to oral thermometry.     OBJECTIV E S : The purpose of this study was to assess the accuracy of two alternative, noninvasive thermometers (tympanic and temporal artery) by comparing them to an oral thermometer.    METHODS : A method- comparison  st...
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Article # 9

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Evidence-Based Practice for Obtaining Blood Specimens  from  a Central Venous Access Device   Sarah J. Mendez, MA, RN, AOCNS     As part of a scheduled policy and procedure review, the department of nursing education at a large urban academic medical center conducted a literature review to  determine  the most up-to-date evidence for central venous access device (CVAD) blood draws. The literature review revealed that the dead space blood draw was the best practice  methodology  because the dead space  methodology , defined as the point at which blood is in the attached syringe when aspirating without flushing, reduced the potential for infection with minimal blood loss from blood discard.     Background:   Laboratory tests such as complete blood count (CBC) and basic metabolic panel (BMP) are an essential part of monitoring eligibility for, and response to, the treatment of patients with cancer   The best methods for ...
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