title: Implementation of best practice for chemotherapy-induced nausea and vomiting in an acute care setting.
abstract: BACKGROUND
  Chemotherapy-induced nausea and vomiting is the commonest side-effect for patients undergoing cancer treatment with chemotherapy. These symptoms can lead to nutritional deficiencies, dehydration and electrolyte imbalance, and negative impacts on quality of life. However, wide gaps exist between clinician and patient perceptions of nausea and vomiting. Effective communication about these symptoms is essential for proper treatment. We conducted a recent chart review to identify gaps in practice regarding chemotherapy-induced nausea and vomiting assessment and documentation.
  
  
  OBJECTIVE
  The goal of this project was to improve local practice in the management of chemotherapy-induced nausea and vomiting in patients with cancer.
  
  
  METHODS
  This study used one pre- and two post-implementation audit strategies utilising the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI-PACES) and Getting Research into Practice (GRiP) module. The study was conducted in the 33-bed oncology ward of a large acute care hospital in Korea from February 2010 to June 2010. To facilitate evidence-based nursing practice, audit-feedback-re-audit cycles strategies were used. The audits included four criteria recommended by the Joanna Briggs Institute.
  
  
  RESULTS
  There were statistically significant improvements in all four criteria. The first post-implementation audit showed that all four audit criteria rated >50% in compliance. At the second follow-up audit, all four audit criteria rated 100% compliance, indicating excellent compliance with best practice. The differences between the pre- and post-data were statistically significant (P < 0.001) for all four audit criteria.
  
  
  CONCLUSIONS
  The results indicate that the pre- and post-implementation audits are an effective method in improvement of assessment, documentation and evidence-based nursing implementation for cancer symptom management.
authors.affiliation: College of Nursing, Nursing Policy and Research Institute, Yonsei University Health System, Seoul, Korea.
authors.forename: Su Kyoung
authors.initials: SK
authors.lastname: Chung
authors.forename: Mee Jung
authors.initials: MJ
authors.lastname: Ahn
authors.forename: Jae Yong
authors.initials: JY
authors.lastname: Yoo
authors.forename: Mona
authors.initials: M
authors.lastname: Choi
authors.forename: Na
authors.initials: N
authors.lastname: Hyang
authors.forename: So Rah
authors.initials: SR
authors.lastname: Woo
authors.forename: So-Sun
authors.initials: SS
authors.lastname: Kim
authors.forename: Sun Ah
authors.initials: SA
authors.lastname: Kim
authors.forename: Eui Geum
authors.initials: EG
authors.lastname: Oh
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D003142:Communication; D004282:Documentation; D055318:Evidence-Based Nursing / Q000458:organization & administration*; D019983:Guideline Adherence; D006801:Humans; D007723:Korea; D008485:Medical Audit / Q000379:methods*; D009325:Nausea / Q000139:chemically induced / Q000628:therapy*; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing*; D009723:Nurse-Patient Relations; D016522:Oncology Service, Hospital; D019982:Organizational Case Studies; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018570:Risk Assessment; D014839:Vomiting / Q000139:chemically induced / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents