ONS Connect - January 2008 - (Page 22)

fivEmiNUTEiNSERviCE AS SEEn In tHE CliniCal Journal of onCology nursing Put Evidence Into Practice to Manage Oral Mucositis [By Pamela Oestreicher, PhD, ONS Scientific Writer] ucositis is a common side effect of chemotherapy and radiation. Oral mucositis can cause significant clinical consequences, including pain, malnutrition, and local and systemic infections. Mucositis can have a negative impact on the overall treatment experience, especially when severe pain or infection occurs. Nurses have a critical role in all aspects of managing mucositis, including teaching oral care, administering pharmacologic inter- M Key Definitions Epithelial cells: layer of cells forming a covering over the epithelium; usually densely packed Magic mouthwash or rinse: typically contains lidocaine, diphenhydramine hydrochloride, and liquid antacids such as magnesium hydroxide, aluminum hydroxide, and simethicone (Maalox ®, Novartis); effectiveness has not been demonstrated. Mucositis: inflammation of the mucous membranes; may extend from the oral cavity throughout the gastrointestinal tract Recombinant human keratinocyte growth factor: palifermin (rHuKGF); potent mitogen for keratinocytes (specialized epidermal cells that synthesize keratin) and epithelial cells ventions, and helping patients cope with symptom distress. Many interventions for managing mucositis exist; however, some are based in tradition or expert opinion and most have not been studied in large, randomized, controlled trials. Additionally, a variety of assessment tools are available, creating confusion and difficulties when comparing interventions across studies. Therefore, ONS assembled the ONS Mucositis Putting Evidence Into Practice® (PEP) team to investigate potential nursing interventions for the condition. Mucositis in the oral cavity is more frequently studied and better characterized in the literature than gastrointestinal mucositis, probably because it is more easily assessed. The mucositis PEP team, thus, chose to examine interventions for the management of oral, rather than gastrointestinal, mucositis. After an extensive literature review, which will be reported in the Clinical Journal of Oncology Nursing in February 2008 (Harris, Eilers, Harriman, Cashavelly, & Maxwell, in press), the team concluded that only oral care protocols are recommended for practice in the management of oral mucositis (see Figure 1). The basic components of an oral care protocol include assessment, patient education, tooth brushing, flossing, and oral rinses. A multidisciplinary, collaborative team approach is important for protocol implementation. Dentists should be included on treatment teams throughout treatment and follow-up. Oral assessment, using a validated tool, should be conducted regularly to assess function, pain, and the oral mucosa. Figure 2 “Five-Minute In-Service” is a monthly feature that offers readers a concise recap of a full-length article published in the Clinical Journal of Oncology Nursing (CJON) or Oncology Nursing Forum. This edition summarizes “Putting Evidence Into Practice®: Evidence-Based Interventions for Management of Mucositis in People Receiving Treatment for Cancer” by Debra J. Harris, RN, MSN, OCN®, June Eilers, PhD, RN, BC, CS, Amber Harriman, RN, Barbara J. Cashavelly, MSN, RN, AOCN®, and Cathy Maxwell, RN, OCN®, CCRC, which will be featured in the February 2008 issue of CJON. Questions regarding the information presented in this Five-Minute In-Service should be directed to the CJON editor at CJONEditor@ons.org. Photocopying of this article for educational purposes and group discussion is permitted. 22 ONS CONNECT JANUARY 2008

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ONS Connect - January 2008 Contents Editor's Note Just In Up Front You Tell Us Up Close & Professional Web Connect Capitol Connection Notice Nursing Now Caregiver Care Five Minute In-Service New Treatments, New Hope Calendar of Events ONS Election Working For You Staying On Top

ONS Connect - January 2008

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