NK3b

 

Research and Dissemination NK3

 

Provide one example, with supporting evidence, of how clinical nurse(s) disseminated the organization’s completed nursing research study to internal audiences. 

 

 

Example b: Clinical Nurse Disseminates Research Findings to Internal Audiences at CHI SVHS

Organization’s Nursing Research
Nursing research provides the scientific basis for the practice of the profession. Using multiple philosophical and theory-based approaches, as well as diverse methodologies, nursing research focuses on “understanding the symptoms of illness; preventing and slowing disease or disability; finding effective approaches to achieving optimal health; and improving clinical settings where care is provided” (American Association of Colleges of Nursing 2006, p. 1).

 

Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS) clinical nurses are encouraged to continually grow professionally, including through involvement with nursing research studies. Clinical nurses are encouraged to inquire into opportunities for improvement in nursing practices every day at CHI SVHS.

 

The CHI SVHS Cancer Treatment Center (CTC) cares for many patients with head and neck cancer. David Pruitt, MD, Radiation Oncologist, and Elizabeth Bright, RN, OCN, Nurse Navigator, inquired about an opportunity to improve outcomes in the care of patients receiving radiation therapy, and they completed a nursing research study to determine whether this opportunity could make a difference.

 

The SMAP-AV: Saving Mucosa with Prophylactic Aloe Vera Therapy study was approved by the IRB in April 2019. The study was completed in March 2023. The purpose of this study was to determine whether the prophylactic use of aloe vera juice in patients receiving external beam radiation therapy, specifically those with a biopsy confirming a diagnosis of head or neck cancer:

  • Would prevent drastic weight loss (>10%)
  • Would prevent patients in this population from requiring a percutaneous endoscopic gastrostomy (PEG) tube
  • Would result in patients in this population experiencing 2 or less on the World Health Organization (WHO) oral mucositis scale during their course of radiation

 

The potential benefits of the study were for patients to experience less treatment-related side effects, most specifically mucositis and esophagitis, and to prevent drastic weight loss during treatment by using the correct consistency of aloe vera juice prophylactically as prescribed during external beam radiation therapy. Aloe vera products and raw Aloe vera leaves are widely available for human consumption through grocers and other retailers in America. Aloe vera juice is like any other vegetable and is sold alongside other produce. It is expected that there is very little risk with ingesting aloe vera juice. Thirty patients were enrolled in the study.

 

Pruitt and Bright completed an IRB application for the nursing research study, “SMAP-AV: Saving Mucosa with Prophylactic Aloe Vera Therapy,” and submitted it on April 1, 2019. (Evidence NK3b-1, IRB Application) The Catholic Health Initiative (CHI) Institute for Research and Innovation Institutional Review Board (CHIRB) reviewed and approved the nursing research study on April 23, 2019, determining the project to be a full IRB review that was expedited. (Evidence NK3b-2, IRB Approval Letter) Pruitt was the CHI SVHS principal investigator for the study, and Bright was the CHI SVHS co-principal investigator. The nursing research study was launched on May 22, 2019 and completed on March 14, 2023.

 

Findings of the Study

The results for the three endpoints of the study for the 30-patient sample were as follows:

  • Patients will not lose greater than 10 percent of their initial body weight:
    • 17/30 (57%) of patients lost less than 10 percent of their initial body weight.
    • 8/30 (27%) patients lost more than 10 percent of their initial body weight but were not compliant with the use of aloe vera juice.
    • 5/30 (17%) of patients did not complete radiation.
    • In addition:
    • 1 patient had a hospital admission and never resumed treatment.
    • 3 patients quit the study due to discomfort or pain.
    • 1 patient had a cardiac arrest and disease that was not due to the study.
  • Patients will not require a PEG tube:
    • 2/30 (7%) of patients had PEG placement during treatment.
    • 1/30 (3%) of patients had a PEG placed prior to consult but did not inform the researchers.
    • 3/30 (10%) of patients required PEG tube placement after completion of treatment.
  • Patients will experience 2 or less on the WHO oral mucositis scale:
    • 2/30 (7%) of patients had a WHO oral mucositis score of 3.
    • 28/30 (93%) of patients had a WHO oral mucositis score of 0-2 at completion of radiation.

 

Clinical Nurse Disseminates Research Findings to Internal Audiences

Clinical Nurse Amy Works, RN, CHI SVHS CTC, was instrumental in the nursing research study, as she worked daily with the patients enrolled in the study. Works obtained patients’ written and verbal consent to participate in the study and provided them with the aloe vera juice. Works weighed the patients at baseline and weekly while undergoing treatment, or more frequently if weight loss was identified. Works asked patients to complete daily journals to record the time they took the aloe vera juice and any side effects they experienced around administration.

 

Works disseminated the findings of the completed nursing research study internally to the CHI SVHS Interprofessional Practice Council (IPC) on July 6, 2023 via PowerPoint presentation. The IPC includes the Vice President Patient Care Services and Assistant Chief Nursing Officer (role of CNO), Clinical Directors of Nursing, Quality Director, Magnet Program Director, and chairs of all the Specialty Councils, which are composed of the chairs of the Unit Based Councils (UBC). As the communication between these councils is two-way, the nursing research results presented at IPC were also disseminated to all the UBCs. (Evidence NK3b-3, IPC Minutes, pg. 4, and Roster, pg. 5, July 6, 2023) (Evidence NK3b-4, SMAP-AV July 2023 PPT)

 

Works successfully disseminated the nursing research study and findings internally to CHI SVHS nursing administration and clinical nurses throughout CHI SVHS.