Pediatric Nursing Residency Team
June 2022
Pediatric Nursing Residency Team
at King Hussein Cancer Center
Pediatric Unit
King Hussein Cancer Center
Amman
Jordan
Khadeejeh Banat, RN
Eman Abdallah, RN
Maryam Ananbeh, RN
Huda AL Hajjeh, RN

 

 

 

Using Cryotherapy to Prevent Mucositis among Pediatric Patients with Cancer

The anxiety and stress of being in the oncology hospital can be overwhelming for any parent of a suffering child with cancer. All nurses try to provide their best care to support those children during their stay in the hospital and make them as satisfied as possible.

The nurses' residency team on the pediatric unit at the King Hussein Cancer Center noticed that oral mucositis is considered one of cancer therapy's most common side effects. Moreover, patients with oral mucositis experience various degrees of pain and changes in function, including difficulty speaking and swallowing. In addition, they noticed that mucositis is linked with an increased length of hospital stay and delays in cancer therapy.

They initiated an evidence-based practice idea about using cryotherapy to prevent mucositis among pediatric patients with cancer. Therefore, preventing oral mucositis can assist patients in adhering to optimal chemotherapy dosages and getting the full benefits of treatment with the slightest discomfort. The pediatric nursing residency team searched the literature and medical databases to find relevant articles supporting their idea. Then, they used the critical appraisal skill program (CASP) tool to appraise the included studies. After that, they prepared a research application to obtain the ethical approval to conduct piloting using a quasi-experimental design of the evidence-based practice intervention for pediatric cancer patients receiving chemotherapy.

During the piloting phase, the team conducted extra efforts by following up with the patients and their parents by phone for 21 days; they also communicated with the emergency room (ER) nurses daily to check if any patients had visited the ER; moreover, they checked the patient's electronic medical record to check if anyone admitted to the hospital due to mucositis. Finally, no one of the patients who received cryotherapy developed oral mucositis. So, the results of the piloting phase help shed light on evidence confirming the effectiveness of oral cryotherapy, which decreases mucositis, the hospital length of stay, is cost-effective, and has few side effects as a preventive approach. Finally, the team modified the policy to implement cryotherapy as a new practice in the pediatric unit. They also afford extra efforts to conduct educational sessions for other pediatric nurses and physicians to influence them to adopt this new practice.

We are always thankful and lucky to have this dedicated team of nurses. The EBP project is the perfect example of a nurse's influence beyond the care given at the bedside, and we are so proud of them.