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
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…
As neutrophils have a short lifespan and a very fast turnover, they can be particularly sensitive to many types of chemotherapy (Wood & Pizzo, 1993), meaning that patients undergoing cancer treatment often present with neutropenia and the related symptoms (Kuderer et al, 2007).
According to the author of the text, different authors have established that children with disabilities experience numerous difficulties in acquisition of language and communication skills. Thus, this situation has motivated researchers to investigate and identify the most effective strategies or methods, which can be used to help such children to acquire language skills.
Medical practitioners agree that individual chemotherapeutic drugs may cause specific adverse effects, and the combination of these drugs would worsen the condition. If these risk conditions are left untreated, some of them may become fatal. This paper will discuss three high risk complications of chemotherapy including chemotherapy-related nephrotoxicity, febrile neutropenia, and chemotherapy-related enterotoxicity.
It is worth noting that efforts geared towards reducing inequalities in health should always take into account factors that are deemed to hinder achieving equality, and this can be achieved through collecting various views of the members of the local community as pertains the sources of those inequalities, as well as on the local health services.
Stimulation of beta receptors cause increase in heart rate and contractility. Beta receptor stimulation on bronchioles is responsible for bronchodilation and maintaining a patent airway. So, blocking these receptors on heart produce desirable effect of decreased heart rate but can compromise airway by causing bronchoconstriction.
The setup then gets corrected after matching the results. It is an authentication method that confirms or denies a patient’s claimed identity (WHO, 2007). This gets done through the use of a biometric scan followed an entry of a personal credential like a password or PIN number.
The author states that the symptoms and complications of neutropenia are immune system related, and include high fever and frequent infections and is diagnosed with a blood cell count. The suggested intervention is giving information and education to both patients and clinical staff about the dangers, risks and avoidance of neutropenia.
In the past, attempts made to explain accountability among these clarifications are unpersuasive. The un-persuasiveness of the previous attempts is because some of the research does not inclusively study all the possible clarifications, some depend on highly interlinked
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