Abstract
The focus of this study was to assess the feasibility and clinical implementation of a standardized assessment for chemotherapy-induced peripheral neuropathy (CIPN) by registered nurses in patients undergoing neurotoxic chemotherapy. A total of 24 registered nurses from 4 different institutions were enrolled into the study. A pre- and posttest design was used to assess changes in nurses' attitudes, knowledge, and perceived skill in CIPN assessment. Using selected data collection instruments, nurses performed standardized assessments during the course of chemotherapy treatments. Patient-reported symptoms, vibratory sensation, deep-tendon reflexes, and touch were collected at three time points during chemotherapy treatment. Results indicated there was no statistically significant change in knowledge of chemotherapy-induced peripheral neuropathy from baseline to the end of the study. However, this finding may be due to poor internal consistency noted among the items of the Nurse Knowledge and Attitudes CIPN Assessment. Implementation of a standardized subjective and objective nursing assessment of CIPN was feasible with a total mean feasibility score of 3.76 (range 0-5) with each individual item scoring between 3.35 and 3.91. The intervention did improve pretest and posttest confidence in performing assessment for CIPN (p = .003).
Highlights
In the year 2011, approximately 207,090 new cases of invasive breast cancer, 142,570 cases of colorectal cancer, and 20,180 cases of multiple myeloma were predicted to be diagnosed in the United
There were no statistically significant differences in Nurse Knowledge and Attitudes between oncology-certified nurses (OCNs) and noncertified nurses, nor were there differences noted based on nursing degree
While a variety of instruments are available for assessment of Chemotherapy-induced peripheral neuropathy (CIPN), the most commonly used instrument is the National Cancer Institute’s Common Terminology Criteria for Adverse Events
Summary
In the year 2011, approximately 207,090 new cases of invasive breast cancer, 142,570 cases of colorectal cancer, and 20,180 cases of multiple myeloma were predicted to be diagnosed in the United. Treatment of these cancers requires the use of chemotherapeutic agents to effect cure or maintain disease control; cancer chemotherapy regimens with more intensive dosing schedules have induced significant neurotoxicity as the dose-limiting side effect. Chemotherapy-induced peripheral neuropathy (CIPN) is the response of the peripheral nervous system to insult imposed following exposure to neurotoxic chemotherapy (Postma & Heimans, 2000). Motor neuropathy results in muscle atrophy and weakness. Autonomic symptoms such as urinary retention, constipation, alterations in blood pressure, and sexual dysfunction can be experienced. Nurses are on the front lines of patientreported symptoms and objective assessment of clinical manifestations of CIPN.
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