Meeting Abstract

JL509. Empowering the Advanced Practitioner to Champion Education of Tumor Lysis Syndrome to the Clinical Nursing Team

Allister B. Chase, MSN, RN, FNP-BC, AOCNP®, Karen Groth, MSN, RN, CNS, ARNP, Colleen Weber, BSN, RN, Linda Schnell, MSN, RN, OCN®, and Loretta Morehead, BSN, RN; Genentech Hematology

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Abstracts From 
JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017

The posters for the abstracts below can be found at:

Context: A metabolic emergency related to malignancy, tumor lysis syndrome (TLS) signals a potentially life-threatening process in which prevention and surveillance are key to positive patient outcomes. Laboratory disturbances that characterize the onset of TLS can include one or more of the following metabolic triggers: hyperkalemia, hyperuricemia, hypocalcemia, and hyperphosphatemia. Heralding a rapid turnover of cellular breakdown, such metabolic disturbances can occur both spontaneously and following treatment initiation, especially with aggressive and/or hematologic malignancies.

Approach: Within the current treatment landscape, targeted therapies are diversifying options for cancer patients. With the development of new targeted oncology drugs TLS has also been observed in patients with cancers that were previously rarely associated with this complication. TLS is a potential complication with patients receiving intravenous therapies, as well as oral agents. As each new therapy brings its own set of management concerns, it is paramount that advanced practitioners (APs) and nurses stay abreast of each regimen’s unique mechanism of action and potential side effects, including TLS. Oncology APs play a critical role in the patient management and prevention of TLS, though it is essential that the entire nursing team be prepared to adequately assess and prevent this life-threatening consequence. Aim: Empower the AP to champion the awareness, education, and mitigation strategies among APs and nursing staff in order to reduce the occurrence and/or effects of TLS.

Summary: Effective management and prevention of TLS necessitates that APs take ownership in the development of an educational plan for their nursing colleagues. An initial survey of the nursing staff may assess their current foundation and understanding of this metabolic disorder. This assessment would include their perception of the pathophysiology, nursing implications, and the individual patient management and education strategies. Building upon this foundation, the AP will work with team educators to develop a learning plan that will accommodate for the current and future treatment landscape enabling the nursing staff to assimilate this knowledge into their patient care. This poster will highlight the educational content that is essential for TLS risk assessment and preventative measures.

Implications: Within their unique role and experience, APs must take the lead in raising awareness of emerging treatments and how they may impact the patient’s risk for TLS. APs can influence patient outcomes through the management of treatment plans, education of patients, AND influencing their nursing colleagues’ knowledge of risk assessment and patient care needs.

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