Quality Care Depends on Knowledge and Action

Two very different articles in this issue of ONCOLOGY Nurse Edition drive home the lesson that evidence-based practice improves cancer care.

The article by authors Cheryl Lee and Christopher Friese describes management and prevention strategies to address bacterial infection in adult cancer patients. The authors include current guidance from the Oncology Nursing Society (ONS), National Comprehensive Cancer Network (NCCN), the Centers for Disease Control and Prevention (CDC), and other national and international organizations.

Since bacterial infections interrupt critically important chemotherapy regimens, their management is essential to cost-effective care, a good quality of life for the patient, and, ultimately, patient survival. Because certain infection-control practices not recommended by current guidelines continue to be used by oncology healthcare providers, there is a need for education and redirection of practice in this area. Therefore, critically important are the frequently updated evidence-based recommendations for patient care that are put forward by ONS in its Putting Evidence Into Practice (PEP) summaries, including nursing interventions aimed at reducing infection risk and impact in this special population. Key infection-control domains as outlined by the ONS include hygiene; selection, placement, and management of IV catheters; special care considerations and assessment for neutropenia; environmental considerations; and chemoprevention.

In addition, early management of an infectious process is of particular critical importance in cancer patients, with proactive best practice and education approaches needed to decrease the risk of sepsis and related complications. As the authors conclude, in addressing infection prevention and control in patients with cancer, astute clinical assessment and rapid intervention with proven therapies, coupled with nonpharmacological strategies, increase the likelihood of optimal patient outcomes.

As part of the case study in this issue presented by Chasity Walters, there is an excellent summary of the literature to date on the impact of near-miss reporting as an “early warning system” in advance of actual events occurring that would have a negative impact on patient safety. Since such events occur much more often than actual medical errors, they lend themselves to quantitative analysis and allow us to review the contributing factors so system changes can be made in the procedures and processes that cause them.

Addressing and eliminating the root cause of a problem is far more effective than working around a problem, especially when it relates to the safety of patients. As oncology nurses, with 24/7 responsibility for patients, we have both the opportunity and the responsibility to incorporate voluntary reporting of events and near misses into our practices.

Both articles in this issue offer important guidance as well as challenges for us as oncology nurses who, as health professionals, are always looking to improve patient care. The evidence is there for us to apply; we just have to have the knowledge and act on it.