Reducing Oral Mucositis: A Quality Improvement Project in a Pediatric Hematology-Oncology Setting

Background: Oral mucositis is a prevalent problem in children receiving chemotherapy. Complications of oral mucositis include increased risk of infection and complications, increased length of hospital stay, and increased cost of care for the hospital and patient.

Local Problem: There were no unit-specific guidelines or interventions in place for prevention of oral mucositis in a tertiary pediatric hematology-oncology care unit. A hospital policy and evidence-based guideline for best practice in prevention of oral mucositis secondary to chemotherapy administration was implemented to decrease incidence of oral mucositis.

Methods: An evidence-based oral cryotherapy guideline was introduced on an 18-bed hematology-oncology unit in a suburban children’s hospital. Participants included pediatric hematology and oncology staff such as registered nurses, specialized physicians and nurse practitioners, nurse educators, nurse leaders, clinical nurse specialists, and quality nurse specialists.

Intervention: Nursing compliance with cryotherapy guideline recommendations and nursing perception of the intervention was assessed through nursing documentation and surveys. Results: Nursing perception of acceptability, appropriateness, and feasibility of a cryotherapy guideline and documentation of cryotherapy efforts and mucositis grading were evaluated with Chi-square analysis. No significant differences in acceptability (p=0.48) and appropriateness (p= 0.45) were found. Participant perception of feasibility (p=0.05), nursing documentation of mucositis scores (p=0.0002) and implementation of cryotherapy (p=0.014) improved.

Conclusions: Implementation of a cryotherapy guideline has been shown to positively impact nursing quality of care and documentation while decreasing patient harm.

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Work Title Reducing Oral Mucositis: A Quality Improvement Project in a Pediatric Hematology-Oncology Setting
Access
Open Access
Creators
  1. Hailey Cleveland
  2. Sheilah Yohn
  3. Paul Logan
  4. Sharilee Hrabovsky
Keyword
  1. Cryotherapy
  2. Oral cryotherapy
  3. Oral mucositis
  4. Mucositis
  5. Children
  6. Pediatric
  7. DNP project
License No Copyright - U.S.
Work Type Project
Acknowledgments
  1. Krysta Spangler
  2. Kevin Mulieri
  3. Diane Berish
Publication Date 2024
Language
  1. English
Deposited February 23, 2024

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Version 1
published

  • Created
  • Updated
  • Updated Acknowledgments Show Changes
    Acknowledgments
    • Krysta Spangler, Kevin Mulieri, Diane Berish
  • Added Creator Hailey Cleveland
  • Added Creator Sheilah Yohn
  • Added Creator Paul Logan
  • Added Creator Sharilee Hrabovsky
  • Updated Keyword Show Changes
    Keyword
    • cryotherapy, oral cryotherapy, oral mucositis, mucositis, children, pediatric
    • cryotherapy, oral cryotherapy, oral mucositis, mucositis, children, pediatric, DNP project
  • Added Cleveland_Final draft_2.23.24.docx
  • Updated License Show Changes
    License
    • https://rightsstatements.org/page/NoC-US/1.0/
  • Published
  • Updated Keyword Show Changes
    Keyword
    • cryotherapy, oral cryotherapy, oral mucositis, mucositis, children, pediatric, DNP project
    • Cryotherapy, Oral cryotherapy, Oral mucositis, Mucositis, Children, Pediatric, DNP project
  • Updated Description Show Changes
    Description
    • Abstract
    • Background: Oral mucositis is a prevalent problem in children receiving chemotherapy. Complications of oral mucositis include increased risk of infection and complications, increased length of hospital stay, and increased cost of care for the hospital and patient.
    • Local Problem: There were no unit-specific guidelines or interventions in place for prevention of oral mucositis in a tertiary pediatric hematology-oncology care unit. A hospital policy and evidence-based guideline for best practice in prevention of oral mucositis secondary to chemotherapy administration was implemented to decrease incidence of oral mucositis.
    • Methods: An evidence-based oral cryotherapy guideline was introduced on an 18-bed hematology-oncology unit in a suburban children’s hospital. Participants included pediatric hematology and oncology staff such as registered nurses, specialized physicians and nurse practitioners, nurse educators, nurse leaders, clinical nurse specialists, and quality nurse specialists.
    • Intervention: Nursing compliance with cryotherapy guideline recommendations and nursing perception of the intervention was assessed through nursing documentation and surveys.
    • Results: Nursing perception of acceptability, appropriateness, and feasibility of a cryotherapy guideline and documentation of cryotherapy efforts and mucositis grading were evaluated with Chi-square analysis. No significant differences in acceptability (p=0.48) and appropriateness (p= 0.45) were found. Participant perception of feasibility (p=0.05), nursing documentation of mucositis scores (p=0.0002) and implementation of cryotherapy (p=0.014) improved.
    • Conclusions: Implementation of a cryotherapy guideline has been shown to positively impact nursing quality of care and documentation while decreasing patient harm.
    • Keywords: Oral cryotherapy, oral mucositis, mucositis, cryotherapy, children, pediatric
    • Conclusions: Implementation of a cryotherapy guideline has been shown to positively impact nursing quality of care and documentation while decreasing patient harm.
  • Updated
  • Updated

Version 2
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  • Deleted Cleveland_Final draft_2.23.24.docx
  • Added Cleveland_Final draft_2.23.24_signature_removed.pdf
  • Published
  • Updated