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Starting a Chemotherapy Orientation Class

  • 1.  Starting a Chemotherapy Orientation Class

    Posted 07-29-2019 11:20

    The infusion center that I work at is currently trying to organize an education class for patients to orient them to our center and provide a foundation for their education. Would anyone have any information on how we should structure the program or what we should focus on? Our main goals are to increase patient self care, reduce anxiety related to treatment, and streamline the initial education usually completed by the assigned nurse that first day. I would definitely appreciate any input from you all as we move forward bringing this class to fruition.  

    Brandon Rodriguez OCN
    University Medical Center of El Paso
    Cell: 915-433-3875

  • 2.  RE: Starting a Chemotherapy Orientation Class

    Posted 07-30-2019 08:31
    We have a clinic RN who teaches a 1 hour one-on-one with the patient (encourages patient to bring /family/caregivers).  The class may go longer depending on patient, level of understanding, questions etc.  She reviews the regimes drug(s), side effects, gives them a patient education print out on each drug, goes over take home prescriptions, stresses importance of infection control, good hygiene, nutrition, hydration, and more.  Our care care navigators facilitate an orientation class on Tuesdays at 10:00 am and Thursdays at 2:00 pm.  The purpose of this class is to give the patient/family/caregiver a tour of the infusion center, discuss registration check-in, wait time, discharge and making return appointments.  After the tour, we go into the conference room and give each patient a cancer journey binder which contains diagnosis specific education materials and community support resources.  We review the contents, introduce them to the Integrative Medicine Program which provides free nutrition counseling and complementary therapies (massage, reflexology, reiki/healing touch) through their treatment journey and up to 6 months after treatment finished. Funding for the program came from a grateful family who donated proceeds from a fundraiser.  After that, they can continue to participate in the program on a fee for service basis.  Contents of the binder include:  booklet/print out on the type of cancer the patient has; ACS booklets (nutrition, chemo, radiation, distress); print outs on infections and cancer patients; appetite changes; nausea/vomiting; diarrhea; dehydration; fatigue; sleep problems; skin changes; mouth sores;  coping checklist for patients; coping checklist for caregivers; ACS boutique contact info; ACS, 4th Angel and Cancer Hope Network telephone and online support programs; our support group meetings; Patient Resource magazine on Surviving; Patient Resource Cancer Guide Magazine.  We have the DigniCap system so we provide information on that as well so if the patient is interested in hair preservation, he/she can contact company and make financial arrangements prior to beginning treatment.  Breast cnacer patients are also given information on bras, prostheses etc. There is no charge for the classes or for the binder of resources prepared and given to the patients.

    Deborah Schmitz RN BSN
    Cancer Care Navigator
    East Jefferson General Hospital
    Metairie LA

  • 3.  RE: Starting a Chemotherapy Orientation Class

    Posted 08-01-2019 11:20
    Hi. If you're also interested in published examples, here are a few:

    Jivraj, N., Gallagher, L. O., Papadakos, J., Abdelmutti, N., Trang, A., & Ferguson, S. E. (2018). Empowering patients and caregivers with knowledge: The development of a nurse-led gynecologic oncology chemotherapy education class. Canadian Oncology Nursing Journal, 28(1), 4–12.

    Kean, C. C., Iverson, L., & Boylan, A. (2016). Evaluation of a Chemotherapy and Medication Education Process for Patients Starting Cancer Treatment. Clinical Journal of Oncology Nursing, 20(4), 364–366.

    Portz, D., & Johnston, M. P. (2014). Implementation of an Evidence-Based Education Practice Change for Patients With Cancer. Clinical Journal of Oncology Nursing, 18, 36–40. -- includes "One-hour patient teaching session by treatment nurse" and "Patient reinforcement of teaching at first chemotherapy/biotherapy visit" etc.

    Koss, T. S., Bires, A. M., Cline, T. W., & Mason, D. L. (2018). Evaluation of an Educational Video: What to Expect on the First Day of Chemotherapy. Critical Care Nursing Quarterly, 41(2), 142–160.

    Dalby, C. K., Nesbitt, M., Frechette, C. A., Kennerley, K., Lacoursiere, L. H., & Buswell, L. (2013). Standardization of Initial Chemotherapy Teaching to Improve Care. Clinical Journal of Oncology Nursing, 17(5), 472–475.

    Garcia, S. (2014). The Effects of Education on Anxiety Levels in Patients Receiving Chemotherapy for the First Time: An Integrative Review. Clinical Journal of Oncology Nursing, 18(5), 516–521.

    Mawhinney, M. W. R., Warden, J., & Stoner, N. (2019). The oral education clinic: A pharmacist- and nurse-led clinic to support patients starting oral systemic anti-cancer treatments. Journal of Oncology Pharmacy Practice, 25(2), 449–453.

    And there are relevant ONS Congress abstracts like the following from

    Amy Rettig, MSN, MALM, RN, ACNS-BC PMHNP-BC, CBCN®, Michael Berger, PharmD, Nicole Muscari, BSN, RN, OCN®, Lindsey Radcliff, BSN, RN, and Donna LaBarge, BSN, RN, OCN®, all at the Ohio State University Wexner Medical Center–The Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH
    Objective: Participants will discover the effect of a targeted intervention on knowledge assessment of newly prescribed chemotherapy patients with breast cancer.
    Topic Significance and Study Purpose, Background, and Rationale: Patients and families often report that information needs are not met. Specific time points for education to best support patients across the continuum of breast cancer care is unknown. In a systematic review, Chan et al. (2012) concluded that orientation programs may or may not impact knowledge gained by patients. A purpose of this program was to determine the impact of an oncology nursing education intervention on patient knowledge at the chemotherapy treatment prescription time point.
    Methods, Intervention, and Analysis: Newly diagnosed patients prescribed chemotherapy for breast cancer were referred (2012–2013) or registered (2013–present) for chemotherapy orientation class. Taught by medical oncology RNS, chemotherapy infusion RNs and clinical pharmacists, the class provided safety information about chemotherapy and basic symptom management. Initially, 2 true/false questions were asked pre/post class: Q1 "A single nurse is responsible for the preparation, crosscheck, administration, and delivery of my chemotherapy" and Q2 "My chemotherapy is prepared specifically for me on the same day I arrive for treatment." Based on feedback from the oncology RNs a third question was included (April 2013): Q3 "I need to call my doctor if I have a temperature of 100.4 degrees." Attendance and assessment participation was voluntary.
    Findings and Interpretation: Since its December 2012 inception, 218 persons, patients and their family members, signed in for the chemotherapy orientation class and 133 patients completed Q1 & Q2 and 105 patients completed Q3. Results showed correct responses were: Q1 56 pre-class and 107 post-class; Q2 91 pre-class and 130 post-class; Q3 80 pre-class and 105 post-class. Percentage improvement for Q1, Q2, and Q3 were 80%, 98% and 100% respectively.
    Discussion and Implications: Results suggest an orientation class may help knowledge gain at the time of the class. It supports other findings that well-designed, high quality research on orientation classes would help oncology nurses determine best practices. Factors to include in future research are knowledge gained after chemotherapy initiation and admission rates.

    Mark Vrabel
    Oncology Nursing Society
    Pittsburgh PA

  • 4.  RE: Starting a Chemotherapy Orientation Class

    Posted 08-02-2019 12:57
    Thank you very much Mark. I'm working my way through the resources right now. I was able to track down a couple so far, but this is definitely a great help. I appreciate it.

    Brandon Rodriguez​

    Brandon Rodriguez RN
    El Paso TX

  • 5.  RE: Starting a Chemotherapy Orientation Class

    Posted 08-18-2019 08:18
    Our center has a dedicated patient education nurse that is scheduled to meet with patients individually prior to the initiation of the first treatment and any change in treatment. Patients are given information on the potential side effects, written info on the specific drugs they are to receive,  ways to decrease side effects, use of anti-emetics, when and how to contact MD office, review of their regimen, home safety, etc. The nurse is given 1 hour with a new patient and 30 minutes with changes in treatment. Patients receiving oral chemotherapies also are scheduled for education.   The nurse also prepares our regimen protocol where our MD will check and sign off on doses and does an initial distress screen. We find this saves time chairside and gives our patients an opportunity to discuss their concerns privately.

    The education nurse helps coordinate insurance approval for oral treatments, referring patients to the needed resources we have available in our clinic to assist procuring financial assistance if needed. The patient is instructed on the medication schedule and home safety. The main goal here, in addition to the information provided to IV treatment,  is to assist our patients to be prepared to administer their medications safely.

    Leisa Larkin RN
    Patient Education Nurse
    Millbrook AL