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Recommended Citation
Granada A, Turri A. Freezing Chemo Induced Neuropathy in Its Tracks. Evidence Based Practice poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Presentation Notes
Evidence Based Practice poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Background
Chemotherapy is known to cause peripheral neuropathy (PN) in 30-60% of patients, with no effective treatments once symptoms occur. Chemotherapy-induced peripheral neuropathy (CIPN) can lead to treatment delays, dose reductions/discontinuation, poor treatment outcomes, and reduced function and quality of life. Cryotherapy is thought to limit circulation of chemotherapy into periphery limiting nerve damage. Prophylactic cryotherapy has been shown to reduce CIPN.
Purpose
PICOT: In adult cancer patients initiating chemotherapy (P), what is the effect of implementing an evidence-based cryotherapy intervention during chemotherapy treatments (I), compared with standard care (C), on patient-reported sensory peripheral neuropathy (toxicity symptom) (O) during chemotherapy treatment (T)?
Implementation plan
This evidence-based practice (EBP) implementation project guided by the Iowa Model (2018) was initiated at a 16-bed infusion clinic in Chicago that delivers chemotherapy based on Quality Oncology Practice Initiative (QOPI®) standards with toxicity monitoring. An implementation team, including manager, clinical nurses, providers, and product vendor, collaborated to review literature and create an evidence-based protocol for cryotherapy (FDA approved) to guide product storage, proper use, and patient education. Nurses were trained to apply gel-packs/sleeves 15 minutes before, during, and 15 minutes after, with pack-change every two hours. Patients received verbal and written cryotherapy information during orientation with option to participate. A retrospective chart review was conducted to identify CIPN incidence without intervention. Cryotherapy was implemented in 2023.
Outcomes
At baseline (n=69, Q3&4 2022), many patients (n=44, 62%) reported CIPN with 54% (n=38) Grade 1 and 9% (n=6) Grade 2. During implementation, cold intolerance was a significant barrier to starting and maintaining cryotherapy. Post intervention (n=12), CIPN were reported less often (n=6, 50%) with all Grade 1, no Grade 2. Data collection continues.
Implications
Overall, results show cryotherapy reduced CIPN frequency and severity. Strategies to address cold tolerance are in progress to improve cryotherapy adherence and efficacy.
Document Type
Poster
Publication Date
11-13-2024
Freezing Chemo Induced Neuropathy in Its Tracks
Background
Chemotherapy is known to cause peripheral neuropathy (PN) in 30-60% of patients, with no effective treatments once symptoms occur. Chemotherapy-induced peripheral neuropathy (CIPN) can lead to treatment delays, dose reductions/discontinuation, poor treatment outcomes, and reduced function and quality of life. Cryotherapy is thought to limit circulation of chemotherapy into periphery limiting nerve damage. Prophylactic cryotherapy has been shown to reduce CIPN.
Purpose
PICOT: In adult cancer patients initiating chemotherapy (P), what is the effect of implementing an evidence-based cryotherapy intervention during chemotherapy treatments (I), compared with standard care (C), on patient-reported sensory peripheral neuropathy (toxicity symptom) (O) during chemotherapy treatment (T)?
Implementation plan
This evidence-based practice (EBP) implementation project guided by the Iowa Model (2018) was initiated at a 16-bed infusion clinic in Chicago that delivers chemotherapy based on Quality Oncology Practice Initiative (QOPI®) standards with toxicity monitoring. An implementation team, including manager, clinical nurses, providers, and product vendor, collaborated to review literature and create an evidence-based protocol for cryotherapy (FDA approved) to guide product storage, proper use, and patient education. Nurses were trained to apply gel-packs/sleeves 15 minutes before, during, and 15 minutes after, with pack-change every two hours. Patients received verbal and written cryotherapy information during orientation with option to participate. A retrospective chart review was conducted to identify CIPN incidence without intervention. Cryotherapy was implemented in 2023.
Outcomes
At baseline (n=69, Q3&4 2022), many patients (n=44, 62%) reported CIPN with 54% (n=38) Grade 1 and 9% (n=6) Grade 2. During implementation, cold intolerance was a significant barrier to starting and maintaining cryotherapy. Post intervention (n=12), CIPN were reported less often (n=6, 50%) with all Grade 1, no Grade 2. Data collection continues.
Implications
Overall, results show cryotherapy reduced CIPN frequency and severity. Strategies to address cold tolerance are in progress to improve cryotherapy adherence and efficacy.
Affiliations
Advocate Illinois Masonic Medical Center