Nurse-Initiated Constipation Education (NICE) protocol: Improved health outcomes in the outpatient oncology setting.

Abstract

237 Background: Many patients living with cancer experience pain requiring opioid therapy, and appreciation of the risks and benefits of opioids has grown in recent years. Opioid induced constipation (OIC) is one of the potential sequelae of opioid therapy. Evidence-based management strategies for OIC utilize lifestyle modifications and over-the-counter medications as initial steps. At a community cancer center, nurses are often the first team members identifying patients with OIC and suggesting management strategies. Thus, providing updated education and tools to nurses is an appropriate means for improving constipation management for patients living with cancer. Methods: Participants in the intervention included RNs and LPNs working in a specific region of the outpatient oncology practice. An evidence-based teaching tool was developed that included five handouts and a 20-minute pre-recorded educational presentation. Changes in nurse knowledge and confidence level were measured using a pretest/post-test design, and constipation related incidents were measured across a 2 month pre- and post-intervention period through review of the triage call tracking system. Data collection also included OIC incidents during the same timeframe. Results: 14 nurse participants completed a pre- and post-test after watching the presentation. Nursing constipation management knowledge scores increased by almost 30% and confidence ratings increased by 16.2%, indicating both an improved knowledge base and comfort level. Constipation-related incidents decreased by 39% post-implementation. Conclusions: Arming nurses with constipation management tools based on current evidence-based practices resulted in improved knowledge and comfort levels and led to decreased patient-reported incidents of constipation and OIC. Utilizing quality evidence-based tools and resources can help to prevent future negative health outcomes.