P1.07-03 Improving Non-Oncology Provider Knowledge of Unique Immunotherapy Adverse Events

Abstract

Immunotherapy use is increasing in frequency among oncology patients as a single treatment or in combination with other modalities. Immunotherapy related adverse events (IrAE) have unique presentations that are often overlooked or misdiagnosed outside of oncology. This IRB approved study sought to evaluate the effectiveness of microteaching on non-oncology providers’ identification of IrAEs and timely initiation of definitive therapy. A second aim was to review result on patient outcomes through review of EHR. Microteaching sessions of 10 minutes in length were scheduled. Sessions occurred before or after staff meetings, at change of shift huddles, and at the monthly ER physician meeting. The six item test pretest/posttest evaluated familiarity with immunotherapy, and identification of and appropriateness of treatment for patients with IrAEs. A paper version of the pretest was given prior to the education which was delivered to nursing in small groups consisting of 2 to10 participants. All physician participants received education at the same time. Immediately following the teaching participants completed the posttest. A retrospective review of electronic health records was conducted to determine timeliness of identification of IrAEs and appropriateness of treatment. A Phi coefficient was calculated to measure the association between pretest and posttest scores on five questions. For all RNs, all items demonstrated an increase in knowledge (p <.0001). Similarly, ER nurses demonstrated an increase in knowledge in all items (p <.0001). Conversely, oncology nurses had better baseline knowledge compared to “all” nurses. This supports the premise that within the oncology specialty, information about irAEs is better known and understood. Although oncology nurses are more prepared to identify and manage these issues, these nurses are not involved in patient care during an ER visit or admission to an ICU. Physicians also had higher baseline scores compared to all nurses, however, to the question ‘are you familiar with the intervention (s) needed to start reversing most immunotherapy adverse events?’ had a significant increase in knowledge following the micro-teaching in-service (p <.0001). Immunotherapy is increasing in use in oncology, as a result, non-oncology providers will progressively encounter patients receiving these agents in non-oncology settings throughout the hospital such as emergency department or ICU. Brief educational sessions were found effective in increasing non-oncology providers knowledge of these immunotherapy agents and their AEs management.