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Monoclonal antibodies: A staff education program
102
Proceedings
of the 2Znd Annual
much information must be learned. The challenge of learning is compounded by fluctuating emotions and insurance companies that demand shorter stays. Once decisions on treatment, participation in research, and central lines are made, there is often “nothing left” emotionally. This decision process often leaves the family void of cognitive energy as well. During informal parent support groups held in our outpatient setting, families revealed how little information they retained during the initial admission. They often characterized the first admission as a “blur.” In addition, our clinic staff report multiple occasions in which a pertinent skill or concept had to be revisited. For this reason, a new educational strategy needed to be initiated to assist and support families in their learning efforts. In response, team members developed a progressive educational program to be carried out during the “downtime” often experienced by patients and families in the outpatient setting. Many concepts and skills will be covered in a series of single-topic sessions by using various teaching modalities. The sessions will be held at a prescheduled time. Families will be aware of the topics and times so that they can attend if they wish, even if the class is not held on their typical “clinic day.” Topics may include neutropenia, research, Broviac/Hickman care, cardiopulmonary resuscitation, parenting skills, late effects, and insurance issues. A proposal will be submitted to the Institutional Review Board. If the proposal is approved, questionnaires with a question to indicate interest and suggested topics for the classes will be sent to families. The form will also allow “write in” topics of interest. A database will be established for the families that reply to the questionnaire. A pre and post quiz will be given to all participants for each class to assess if knowledge was gained. Participants will be entered into the database as well. Last, after 3 months of classes, we will send a survey to all who were entered into the database to assess if families perceived these classes to be helpful. This assessment will determine if classes should
APON
Conference
continue in this format or if changes need to be made. The project will begin in May, 1998. If, after the 3-month assessment, the data indicate an improved sense of knowing and understanding of the skills/concepts, the classes will become a permanent part of our oncology program. Also, we hope to develop a better understanding of when and how adults learn best so that we as staff can plan educational sessions accordingly. Finally, it is anticipated that as families have a better understanding of oncology-related skills/concepts, increased quality of care and compliance at home will result.
Monoclonal Antibodies: A Staff Education Program BSN, RN, Amy Newman, BSN, RN, and Theresa Comer, BSN, RN; Texas Children’s Hospital, Houston, TX
Cheryl Rodgers,
Bone marrow transplants (BMTs) have become a prevalent treatment option for patients with hematologic malignancies, marrow failure, and genetic disorders. Approximately 70% of patients needing a BMT do not have a human lymphocyte antigen (HLA)-matched sibling; therefore, mismatched and unrelated BMTs are being performed more often for these patients. The incidence of graft-versus-host disease (GVHD), a common complication with mismatched and unrelated BMTs, is also increasing. Numerous studies are currently being conducted to identify ways to prevent and treat this complication. Current research at the Texas Children’s Cancer Center includes the study of monoclonal antibodies as a second line treatment for acute GVHD. As the number of patients receiving mismatched or unrelated BMTs at Texas Children’s Hospital significantly increases, staff nurses will be expected to care for more patients experiencing GVHD. In addition, the staff nurses will be expected to participate in the monoclonal antibody study that requires precise administration and appropriate monitoring of these patients. Therefore, a staff education program was developed to inform
Proceedings
of the 22nd Annual
and educate nurses about GVHD and this research protocol. A series of three educational posters will be provided for staff to read and review. The first poster will review the basic concepts of GVHD. The second poster will discuss the common treatment modalities for acute GVHD, and the third poster will explain monoclonal antibodies and the current research protocol. A poster presentation allows staff nurses to read the information at their leisure and to review the information as needed. The final step in the learning process will be an inservice presented by the nurses who created the posters and one of the research physicians. A pre-post test will be administered as an evaluation tool. By having a thorough understanding of GVHD and the treatment options, patient care will be enhanced because it is anticipated that staff nurses will be able to compe-
APON
Conference
103
tently provide information to patients and families. Staff nurses will also be able to collaborate with physicians regarding pertinent information and significant findings while administering the medication. In addition, nurses will be able to competently administer the medication with expedient preparation and minimal delay. With numerous ongoing research studies occurring in pediatric oncology, it is imperative that oncology nurses stay informed of current research. It is anticipated that with a heightened awareness of such research studies, nurses will improve their assistance to patients and families through education and support. This heightened awareness, in turn, increases the nurse’s knowledge base and effectiveness in practice, thereby promoting greater accountability and collaboration with physicians regarding research studies.
Proceedings
of the 2Znd Annual
much information must be learned. The challenge of learning is compounded by fluctuating emotions and insurance companies that demand shorter stays. Once decisions on treatment, participation in research, and central lines are made, there is often “nothing left” emotionally. This decision process often leaves the family void of cognitive energy as well. During informal parent support groups held in our outpatient setting, families revealed how little information they retained during the initial admission. They often characterized the first admission as a “blur.” In addition, our clinic staff report multiple occasions in which a pertinent skill or concept had to be revisited. For this reason, a new educational strategy needed to be initiated to assist and support families in their learning efforts. In response, team members developed a progressive educational program to be carried out during the “downtime” often experienced by patients and families in the outpatient setting. Many concepts and skills will be covered in a series of single-topic sessions by using various teaching modalities. The sessions will be held at a prescheduled time. Families will be aware of the topics and times so that they can attend if they wish, even if the class is not held on their typical “clinic day.” Topics may include neutropenia, research, Broviac/Hickman care, cardiopulmonary resuscitation, parenting skills, late effects, and insurance issues. A proposal will be submitted to the Institutional Review Board. If the proposal is approved, questionnaires with a question to indicate interest and suggested topics for the classes will be sent to families. The form will also allow “write in” topics of interest. A database will be established for the families that reply to the questionnaire. A pre and post quiz will be given to all participants for each class to assess if knowledge was gained. Participants will be entered into the database as well. Last, after 3 months of classes, we will send a survey to all who were entered into the database to assess if families perceived these classes to be helpful. This assessment will determine if classes should
APON
Conference
continue in this format or if changes need to be made. The project will begin in May, 1998. If, after the 3-month assessment, the data indicate an improved sense of knowing and understanding of the skills/concepts, the classes will become a permanent part of our oncology program. Also, we hope to develop a better understanding of when and how adults learn best so that we as staff can plan educational sessions accordingly. Finally, it is anticipated that as families have a better understanding of oncology-related skills/concepts, increased quality of care and compliance at home will result.
Monoclonal Antibodies: A Staff Education Program BSN, RN, Amy Newman, BSN, RN, and Theresa Comer, BSN, RN; Texas Children’s Hospital, Houston, TX
Cheryl Rodgers,
Bone marrow transplants (BMTs) have become a prevalent treatment option for patients with hematologic malignancies, marrow failure, and genetic disorders. Approximately 70% of patients needing a BMT do not have a human lymphocyte antigen (HLA)-matched sibling; therefore, mismatched and unrelated BMTs are being performed more often for these patients. The incidence of graft-versus-host disease (GVHD), a common complication with mismatched and unrelated BMTs, is also increasing. Numerous studies are currently being conducted to identify ways to prevent and treat this complication. Current research at the Texas Children’s Cancer Center includes the study of monoclonal antibodies as a second line treatment for acute GVHD. As the number of patients receiving mismatched or unrelated BMTs at Texas Children’s Hospital significantly increases, staff nurses will be expected to care for more patients experiencing GVHD. In addition, the staff nurses will be expected to participate in the monoclonal antibody study that requires precise administration and appropriate monitoring of these patients. Therefore, a staff education program was developed to inform
Proceedings
of the 22nd Annual
and educate nurses about GVHD and this research protocol. A series of three educational posters will be provided for staff to read and review. The first poster will review the basic concepts of GVHD. The second poster will discuss the common treatment modalities for acute GVHD, and the third poster will explain monoclonal antibodies and the current research protocol. A poster presentation allows staff nurses to read the information at their leisure and to review the information as needed. The final step in the learning process will be an inservice presented by the nurses who created the posters and one of the research physicians. A pre-post test will be administered as an evaluation tool. By having a thorough understanding of GVHD and the treatment options, patient care will be enhanced because it is anticipated that staff nurses will be able to compe-
APON
Conference
103
tently provide information to patients and families. Staff nurses will also be able to collaborate with physicians regarding pertinent information and significant findings while administering the medication. In addition, nurses will be able to competently administer the medication with expedient preparation and minimal delay. With numerous ongoing research studies occurring in pediatric oncology, it is imperative that oncology nurses stay informed of current research. It is anticipated that with a heightened awareness of such research studies, nurses will improve their assistance to patients and families through education and support. This heightened awareness, in turn, increases the nurse’s knowledge base and effectiveness in practice, thereby promoting greater accountability and collaboration with physicians regarding research studies.