Addressing Sexual Health and Ensuring Safe Alternate Route Chemotherapy Administration in Cancer Patients

Newswise — New Brunswick, N.J., April 28, 2016 – The topic of sexual dysfunction may be a difficult one to discuss between healthcare providers and cancer patients. Given the importance of this subject to patients, the nursing and social work teams at Rutgers Cancer Institute of New Jersey further explored this issue in order to improve how the topic of sexual health is addressed and to ensure quality oncology care. The research is being presented at the Oncology Nursing Society’s (ONS) Annual Congress being held this week in San Antonio, Texas.

Based on a needs assessment, nurse Alissa Coslit, BS, RN, OCN; social worker Sara Toth, MSW, LSW, and Executive Director of Oncology Nursing Services Janet Gordils-Perez, DNP, ANP-BC, AOCNP, identified a need to improve their assessment, documentation and management interventions of sexual health at Rutgers Cancer Institute. Data from the assessment revealed 41.1 percent of nurses do not initiate discussion of sexual issues with patients and 45.7 percent do not include the topic of sexuality assessment of patients who are receiving treatment. The data also revealed 51.4 percent feel they are not confident in knowing the sexual health resources that are available.

As a result, the investigators implemented a multi-step intervention plan, which included educating nursing staff on the needs assessment data and alerting them to the sexual health resources available. A multi-disciplinary sexual health committee also was developed to identify opportunities for incorporating interventions into practice. Such education included sessions led by a sex therapist that included role play between health care professional and patient, evidence-based lectures and varied materials. As a result, modifications were made to the electronic nursing documentation tool that prompts nurses to complete an in-depth assessment and provide evidence-based interventions and evaluation. A patient education tool also was developed.

“Sexual dysfunction can be a distressing consequence of cancer treatment that has a negative impact on a patient’s quality of life. With oncology nurses playing a unique role in teaching patients about potential or actual challenges related to their disease and treatment, it is imperative they are fully armed with the knowledge and resources they need to address such an important topic,” notes Gordils-Perez, who is the senior author of the work. She notes the patient teaching sheet, nursing documentation tool and overall education program developed by she and her colleagues is suitable to be adapted by nurses nationwide.

Another program development by Rutgers Cancer Institute nurses presented at the Annual Congress that can be adapted by nurses on the national level addresses the safe administration of chemotherapy or biotherapy through tubing inserted from the outside of the body directly into the kidney. This nephrostomy tube is typically used for patients to void urine, but some cancer patients who have had kidney tumors removed may benefit from receiving certain types of treatment through this vehicle, as it has been shown to preserve kidney function.

“Oncology nurses who are certified in chemotherapy administration must also be proficient in the administration of chemotherapy and biotherapy through other routes. Evidence-based resources on administration procedures with regard to the upper urinary tract are challenging to find, thus we felt it was an important topic to address for both the safety of the patient and to prevent exposure to the nurse,” notes lead author of the work, Kathy S. Morris, BSN, RN, OCN, RNC.

Along with clinical nurse specialist Ellen Sterman, APN-C, AOCNS, the pair conducted a review of best practice literature and developed a policy outlining administration of chemotherapy/biotherapy through a nephrostomy tube. Following adaptation of the policy, they note anecdotal feedback from Rutgers Cancer Institute nurses shows increased confidence in the safe administration and management of patients treated through this approach.

About Rutgers Cancer Institute of New JerseyRutgers Cancer Institute of New Jersey (www.cinj.org) is the state’s only National Cancer Institute-designated Comprehensive Cancer Center. As part of Rutgers, The State University of New Jersey, the Cancer Institute of New Jersey is dedicated to improving the detection, treatment and care of patients with cancer, and to serving as an education resource for cancer prevention. Physician-scientists at Rutgers Cancer Institute engage in translational research, transforming their laboratory discoveries into clinical practice. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 732-235-8614 or visit www.cinj.org/giving. Follow us on Facebook at www.facebook.com/TheCINJ.

The Cancer Institute of New Jersey Network is comprised of hospitals throughout the state and provides the highest quality cancer care and rapid dissemination of important discoveries into the community. Flagship Hospital: Robert Wood Johnson University Hospital. System Partner: Meridian Health (Jersey Shore University Medical Center, Ocean Medical Center, Riverview Medical Center, Southern Ocean Medical Center, and Bayshore Community Hospital). Affiliate Hospitals: JFK Medical Center, Robert Wood Johnson University Hospital Hamilton (CINJ Hamilton), and Robert Wood Johnson University Hospital Somerset.