Putting Evidence Into Practice: Improving Oncology Patient Outcomes

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Chapter 1. PEP Up Your Practice: An Introduction to the Oncology Nursing Society Putting Evidence Into Practice Resources 1
Introduction 1
Overview of the PEP Resources 1
History of the ONS PEP Project 2
ONS PEP Resource Development 4
Applying ONS PEP Resources to Practice 6
Summary 7
References 7
Chapter 2. Assessment and Measurement 9
Integration of the Putting Evidence Into Practice Resources With the Nursing Process 9
Nursing Assessment 10
Selection of Interventions 10
Why Should Nurses Be Concerned About Measurement? 10
Measurement Issues 12
Symptom Dimensions 12
Symptom Clusters 13
Clinical Utility 13
Barriers to Effective Symptom Measurement 17
Survey of Clinical Measurement Tools Used to Evaluate Oncology Patient Problems 17
Characteristics and Work Settings of Advanced Practice Nurses Surveyed 17
Clinical Measurement Tools 18
Reasons for Not Using a Clinical Measurement Tool 18
Selection of Tools for This Book 18
References 22
Chapter 3. Anorexia 25
Problem 25
Incidence 25
Assessment 26
Clinical Assessment and Measurement Tools 26
References 27
Case Study 28
ONS PEP Resource: Anorexia 31
References 35
Chapter 4. Anxiety 37
Problem 37
Incidence 37
Assessment 37
Clinical Measurement Tools 39
References 41
Case Study 41
ONS PEP Resource: Anxiety 43
References 48
Chapter 5. Caregiver Strain and Burden 51
Problem 51
Incidence 51
Assessment 51
Clinical Measurement Tools 52
References 54
Case Study 54
ONS PEP Resource: Caregiver Strain and Burden 57
References 61
Chapter 6. Chemotherapy-Induced Nausea and Vomiting 63
Problem 63
Incidence 63
Assessment 64
Clinical Measurement Tools 64
References 67
Case Study 68
ONS PEP Resource: Chemotherapy-Induced Nausea and Vomiting 71
References 80
Chapter 7. Constipation 85
Problem 85
Incidence 85
Assessment 85
Clinical Measurement Tools 88
References 90
Case Study 90
ONS PEP Resource: Constipation 93
References 100
Chapter 8. Depression 105
Problem 105
Incidence 105
Assessment 105
Clinical Measurement Tools 106
References 106
Case Study 109
ONS PEP Resource: Depression 111
References 116
Chapter 9. Diarrhea 119
Problem 119
Incidence 119
Assessment 119
Clinical Measurement Tools 121
References 122
Case Study 123
ONS PEP Resource: Diarrhea 125
References 132
Chapter 10. Dyspnea 135
Problem 135
Incidence 135
Assessment 135
Clinical Measurement Tools 135
References 136
Case Study 138
ONS PEP Resource: Dyspnea 141
References 146
Chapter 11. Fatigue 149
Problem 149
Incidence 149
Assessment 149
Clinical Measurement Tools 149
References 150
Case Study 153
ONS PEP Resource: Fatigue 155
References 166
Chapter 12. Lymphedema 175
Problem 175
Incidence 175
Assessment 175
Clinical Measurement Tools 176
References 178
Case Study 179
ONS PEP Resource: Lymphedema 183
References 190
Chapter 13. Mucositis 193
Problem 193
Incidence 193
Assessment 193
Clinical Measurement Tools 194
References 198
Case Study 199
ONS PEP Resource: Mucositis 201
References 209
Chapter 14. Pain 215
Problem 215
Incidence 215
Assessment 215
Clinical Measurement Tools 215
References 216
Case Study 220
ONS PEP Resource: Pain 223
References 230
Chapter 15. Peripheral Neuropathy 235
Problem 235
Incidence 235
Assessment 235
Clinical Measurement Tools 235
References 236
Case Study 240
ONS PEP Resource: Peripheral Neuropathy 243
References 249
Chapter 16. Prevention of Bleeding 253
Problem 253
Incidence 253
Assessment 253
Clinical Measurement Tools 254
References 255
Case Study 255
ONS PEP Resource: Prevention of Bleeding 257
References 263
Chapter 17. Prevention of Infection 267
Problem 267
Incidence 267
Assessment 267
Clinical Measurement Tools 269
References 270
Clinical Example 271
ONS PEP Resource: Prevention of Infection 273
References 280
Chapter 18. Sleep-Wake Disturbances 285
Problem 285
Incidence 286
Assessment 286
Clinical Measurement Tools 287
References 289
Case Study 289
ONS PEP Resource: Sleep-Wake Disturbances 291
References 295
Chapter 19. Evidence-Based Practice: Its Role in Quality Improvement 299
Creating an Evidence-Based Practice Environment Through Education 300
Clinical Example: “Spreading the PEP” Through Unit Bulletin Boards and Staff Team Huddles 300
Creating an Evidence-Based Practice Environment Through a System Change 302
Clinical Example: Putting PEP Into Practice: Formation of a Neutropenia Improvement Project Team in a Community-Based Hospital 303
Creating an Evidence-Based Practice Environment Through Performance Evaluation 304
Clinical Example: Competency Testing of the ONS PEP Resource Information 305
Clinical Example: Using the ONS PEP Process for Other Clinical Problems 306
Promoting Evidence-Based Practice in the Workplace 307
References 307
Epilogue 309
Index 311
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