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Decreasing Rates of Neutropenia in the Chemotherapy Patient - Research Paper Example

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Decreasing Rates of Neutropenia in the Chemotherapy Patient

This paper will identify the evidence for the change in practice and then outline a method to implement the project using Rosswurm and Larrabee’s model for evidence-based change (Rosswurm & Larrabee, 1999). Finally, a measurable plan for evaluating the success of the evidence-based change will be outlined to ensure that the results are living up to the expectations outlined by the evidence. Rosswurm and Larrabee’s model for evidence-based change (1999) splits the process into six different steps; Step 1 – Assess the need for changes in practice; Step 2 – Link the problem to interventions and outcomes; Step 3 – Synthesize best evidence; Step 4 – Design a change in practice; Step 5 – Implement the change and evaluate the change in practice; and Step 6 – Integrate and maintain the changes. This covers all the aspects needed to successfully implement the changes based on the evidence from the literature review. Step 1 – Assess the Need for Changes in Practice It has been shown that neutropenia is 'not only a life-threatening complication, it can also lead to a decision to reduce chemotherapy intensity in subsequent treatment cycles' (Cameron, 2009, p101), which in itself suggests that neutropenia is a critical issue for those undergoing chemotherapy and those in charge of their care. Educating nurses and allowing them to pass this information onto patients who are at risk can reduce secondary infections in those who are suffering from neutropenia (Nirenburg et al, 2006), again suggesting that implementing a proper regime for the education of nurses and patients alike will have a significant effect on the number of cases of neutropenia and the number of complications from each case. Step 2 – Link the Problem to Interventions and Outcomes Rosswurm & Larrabee (1999) suggest that is important to first define the problem using standard nursing classification systems as a way of linking them to interventions and outcomes. There are a number of ways of classifying chemotherapy-associated neutropenia, and the ones that will be used here are the International Classification of Diseases (ICD), Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC). International Classification of Diseases The International Classification of Diseases is currently in its tenth year of publication and is synthesized by the World Health Organization. Neutropenia is classified under D70 (Agranulocytosis) and is split further into seven different causes, of which drug-induced is the one applicable to the topic at hand. There is a further note, which suggests that it is imperative to ‘use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced. This gives the codes Y43.1 (Anti-neoplastic antimetabolites), Y43.2 (Anti-neoplastic natural products), and Y43.3 (Other anti-neoplastic drugs), all of which can and should be used where appropriate in a discussion linking interventions and outcomes relevant to chemotherapy-induced neutropenia. Nursing Interventions Classification The purpose of the Nursing Interventions Classification is to provide details of patient outcomes in a nursing context. It is these that are most appropriate to nursing intervention and give a classification of the type of intervention that a nurse can administer in certain cases (Bulechek & McCloskey, ).The ones relevant to drug-induced neutropeni ...Show more


Decreasing Rates of Neutropenia in the Chemotherapy Patient Student School Course Number and Title Professor Session Decreasing Rates of Neutropenia in the Chemotherapy Patient Design for Change One of the most important aspects of nursing research is how the results can be used in evidence-based practice, or how the research can be used in a practical manner…
Author : kristin37
Decreasing Rates of Neutropenia in the Chemotherapy Patient
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