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Mary Fournogerakis, BSN, RN, OCN Rebecca Martin, BSN, RN, OCN, BMTCN

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Presentation on theme: "Mary Fournogerakis, BSN, RN, OCN Rebecca Martin, BSN, RN, OCN, BMTCN"— Presentation transcript:

1 Mary Fournogerakis, BSN, RN, OCN Rebecca Martin, BSN, RN, OCN, BMTCN
Standardizing Cerebellar Assessment and Documentation in Patients Receiving High-Dose Cytarabine Mary Fournogerakis, BSN, RN, OCN Rebecca Martin, BSN, RN, OCN, BMTCN

2 Objectives Identify why a cerebellar assessment is important and necessary with high-dose cytarabine Describe how to implement a standardized cerebellar assessment tool into the electronic health record

3 Who We Are Froedtert & Medical College of Wisconsin
Academic Medical Center 500 beds Clinical Cancer Center Ambulatory Clinics 240,000 visits annually Day Hospital 32,000 encounters

4 High-Dose Cytarabine Part of post-induction therapy for many patients with acute myeloid leukemia Irreversible neurotoxicity is a potential dose-limiting side effect in 8% to 26% of patients Important to complete a cerebellar assessment prior to each dose

5 Problem Inconsistency in documentation of cerebellar assessment
Variability in: Frequency Type Number of tests performed Thoroughness of documentation

6 Pre-Intervention Documentation
Documentation was simply “cerebellar exam intact” in a patient care note Vague statement Didn’t reflect what was done Unable to determine baseline Unable to compare assessments Hard to find Required extensive chart review of patient care notes

7 Purpose To develop an accessible, standardized workflow for the assessment and documentation of cerebellar function prior to administering high-dose cytarabine

8 Interventions Literature Review Collaborated with oncology physicians
Educated staff Created electronic documentation tool and linked to eMAR Presented to nursing Shared Governance council Standardized cerebellar assessment tool created Collaborated with oncology physicians Literature Review eMAR = electronic medication administration record

9 Cerebellar Assessment Tool

10 Medication Administration Record

11 Flow sheet – Inpatient Synopsis – Outpatient

12 Project Outcomes Standardized method for assessment and documentation
Improves efficiency by eliminating free text Compares historical assessments Promptly identifies adverse reactions

13 Future Directions Replicate with other medications with the potential of neurotoxicity Blinatumomab Develop and implement standardized tools to improve efficiency and thoroughness of documentation for other critical side effects Emphasize important role nursing has in assessment and mitigation of potential side effects

14 Mary Fournogerakis, BSN, RN, OCN
Questions? Contact information: Mary Fournogerakis, BSN, RN, OCN

15 References Baker, W. J., Royer, G. L., Jr., & Weiss, R. B. (1991). Cytarabine and neurologic toxicity . Journal of Clinical Oncology,9(4), Brown, C. (2010). Cerebellar assessment for patients receiving high-dose cytarabine: A standardized approach to nursing assessment and documentation. Clinical Journal of Oncology Nursing,14(3), Szoch, S., & Kaiser, K. S. (2015). Implementation and evaluation of a high-dose cytarabine neurologic assessment tool. Clinical Journal of Oncology Nursing,19(3),

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