BACKGROUND: Antineoplastic drugs (ADs) are widely used in healthcare settings and dangerous to healthcare workers who may be exposed. Closed-system transfer devices (CSTDs) are engineering controls designed to reduce environmental exposure to ADs. OBJECTIVES: This study documents AD residue on surfaces in a high-volume outpatient infusion clinic and an inpatient oncology unit before and after the implementation of CSTDs to determine whether this engineering control decreased contamination with ADs. METHODS: The authors collected 60 surface wipe samples pre-and postimplementation in each setting to assess the detection of etoposide and cyclophosphamide. The authors also conducted semistructured interviews with nurse managers and observed environmental services workers to evaluate training and cleaning practices, respectively. FINDINGS: This study did not find a significant difference between contamina-tion for either drug in either clinical setting after the implementation of CSTDs. Implications for nursing practice include standardizing appropriate cleaning products and protocols, assigning specific cleaning tasks to nursing, and ensuring that institutional policies for safe handling of ADs are followed.
BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a persistent problem in ambulatory oncology and is associated with low serum vitamin D levels. OBJECTIVES: This quality improvement project evaluated a practice change ata ruralcommunity cancer center (preimplementation: N = 20; post-implementation: N = 27) aimed at mitigating CIPN associated with paclitaxel treatment in patients with breast cancer by recommending vitamin D supplementation. The key goal was to reduce CIPN incidence by at least 10%. METHODS: A pre-/postimplementation comparison of CIPN incidence among patients with breast cancer receiving paclitaxel was used before (January 2022 to December 2023) and after (June 2024 to December 2024) a practice change recommending vitamin D supplementation. FINDINGS: CIPN incidence decreased from 80% (n = 16 of 20) preimplementation to 67% (n = 18 of 27) postimplementation, a 13% reduction that met the 10% goal. All patients with vitamin D insufficiency (N = 11) developed CIPN.
In patients with cytokine release syndrome receiving chimeric antigen receptor (CAR) T-cell therapy, fever often leads to unnecessary use of IV antibiotics. Early antibiotic de-escalation may reduce antibiotic exposure without compromising the efficacy or safety of cellular therapies. The purpose of this quality improvement project was to decrease antibiotic days by implementing risk stratification and de-escalation processes on an inpatient cellular therapy unit. The intervention reduced IV antibiotic days by 39% across three months, indicating that the risk stratification and de-escalation effectively decreased antibiotic exposure without compromising patient safety.
BACKGROUND: Cancer-related fatalistic beliefs and perceived information ambiguity may reduce engagement in cancer prevention and screening. Fatalistic beliefs reflect perceptions that cancer outcomes are inevitable despite prevention or treatment, whereas perceived information ambiguity reflects uncertainty about available health information. OBJECTIVE: This study examined associations among perceived information ambiguity, cancer-related fatalistic beliefs, and lung cancer screening (LCS) uptake among LCS-eligible adults. METHODS: A cross-sectional online survey was conducted from December 2023 to February 2024. Participants were LCS-eligible adults with at least a 20 pack-year smoking history, were a current smoker or quit smoking within the past 15 years, and had no prior lung cancer history. The primary outcome was LCS uptake within the pastyear; predictors were cancer-related fatalistic beliefs and perceived information ambiguity. Descriptive statistics and multinomial multivariable logistic regression were used to examine associations. (Continued on the next page)
BACKGROUND: The U.S. oncology workforce is not increasing at the same pace as the cancer survivor population. Cancer care requires extended coordination across multiple disciplines. Oncology teams need technological solutions to support patient surveillance and meet growing care demands. OBJECTIVES: The purpose of this study was to develop and test an artificial intelligence (AI) approach to identify and track care states in patients with prostate cancer. METHODS: The study examined data from a retrospective cohort of 180 patients to develop ground truth care state assignments with parameters set by clinicians, then developed an AI model that set its own parameters for care state assignment and tested it on this cohort dataset. The study assessed the agreement between assignments made by the AI model and clinician specialists. FINDINGS: The AI model produced care state assignments for all 180 patients in less than one second, and agreement with the clinician-assigned care state was 95%.
