Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  K. Melissa Hayes, DNP, ANP-BC
 

 

DNP Project Abstract

Assessing the Efficacy of Chemotherapy Education

Purpose
Receiving a cancer diagnosis and making the decision to begin chemotherapy can be overwhelming in addition to learning about the medications and how to manage their side effects appropriately (Jabeley et al., 2020). Chemotherapy education is vital to ensure the best patient outcomes (Coolbrandt et al., 2013). This DNP quality improvement scholarly project addressed the timing of chemotherapy education for patients beginning a new intravenous chemotherapy regimen and its effect on patients’ knowledge and preparedness. The aim of this project was to improve the patient experience of care through improved preparedness for IV chemotherapy treatment as measured by an increase in the Leuven Questionnaire on Patient Knowledge of Chemotherapy (L-PaKC) score from baseline (Coolbrandt et al., 2013).

Methods
The setting of this quality improvement project is an outpatient hematology/oncology practice housed in an academic medical center within the outpatient chemotherapy infusion center. Participants were patients receiving new IV chemotherapy treatment regimens as an outpatient who met inclusion criteria. Ten patients for a baseline group were identified and education was delivered per current practice. Ten patients were identified for an intervention group and education was delivered via phone prior to the day of chemotherapy. Time spent providing education via phone by NP was recorded. The L-PaKC questionnaire was used to assess patients’ knowledge on chemotherapy for both the baseline and intervention group on the day of their IV chemotherapy treatment. Descriptive statistics were used to analyze the collected data. The mean L-PaKC questionnaire scores were calculated for the baseline and intervention groups and were compared. The mean length of time spent making phone calls by the NP was calculated.

Results
The mean L-PaKC questionnaire score for the baseline group was 86.2% compared to 90.7% for the intervention group. The aim of this quality improvement project was ultimately met with an improvement in the mean L-PaKC questionnaire score of the intervention group, however by a lower percentage than expected at approximately 5%. However, a greater improvement in patient satisfaction was anecdotally observed. The average time of 20 minutes spent by the NP was burdensome, thus the feasibility of one-on-one education prior to IV chemotherapy provided by the NP via phone is minimal.

Implications for Practice
Previous experience with IV chemotherapy may have been a confounding factor making the higher mean score of the intervention group more meaningful. A strength of this project was the noticeable improvement in patient satisfaction among the intervention group. A weakness of this project was the small sample size. The timing of phone calls (after hours) as well as the increase in phone calls from patients afterwards were not accounted for and added to the overall time spent. The feasibility of chemotherapy education via phone by the NP prior to the first day of a new treatment regimen may be minimal in a busy practice. Implications for practice include adapting the change and developing a group chemotherapy class for patients and caregivers to attend prior to the first day of a new IV chemotherapy regimen. This would allow for more staff to be involved and increase feasibility. Further study is indicated to assess the outcomes of knowledge and preparedness as well as patient satisfaction for a group chemotherapy class for patients and caregivers to attend prior to the first day of a new IV chemotherapy regimen.