Episode 322: Nursing Strategies to Reduce Readmission Rates for Patients With Cancer
Release Date: 07/26/2024
Episode 437: Precision Oncology: What We’ve Learned and What’s Ahead
The ONS Podcast
“Biomarker testing isn’t just about generating more information. It’s about answering very practical questions for our patients. Can we identify disease earlier? Can we understand whether treatment is working? Are we able to identify why a cancer has become resistant? Ultimately, I think that’s where precision oncology becomes very meaningful. It’s not about the molecular report sitting in the chart. It’s about taking that information and using it to make the best possible decision for our individual patients,” ONS member Erica Bello Rodriguez, MSN, AGNP, NP-C, AOCNP®, oncology...
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Episode 436: Oncologic Emergencies 101: Hypersensitivity Reactions
The ONS Podcast
“The most important thing related to hypersensitivity reactions is that there is often a potential for rapid progression, and that’s what makes these reactions an oncologic emergency. The patients may have symptoms that are mild, and that quickly can progress to respiratory compromise, hypertension, cardiovascular issues, or anaphylaxis. Early recognition is so important, so we don’t want to wait for our patient to become hypotensive or significantly hypoxic before we identify that they’re having a serious reaction,” ONS member Christina Matousek, DNP, RN, OCN®, patient education...
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Episode 435: An Overview of Hodgkin Lymphoma for Oncology Nurses
The ONS Podcast
“The accumulation of these malignant and reactive cells, that’s what causes the lymph nodes to get big. That’s why they grow. And that’s why the classic presentation is persistent, painless, enlarged lymph nodes. So when we think of the pathophysiology of Hodgkin lymphoma, there are really two processes contributing to the presentation: One is the physical effects of enlarging lymph nodes or the involved organs. The second is the systemic inflammatory response generated by it and its surrounding immune environment,” ONS member Victoria Krogg, DNP, APRN-CNP, AOCNP®, nurse...
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Episode 434: Oncology–Psychiatric RN Collaboration to Support Psychosocial Health
The ONS Podcast
“Nurses are the front line. Oncology nurses see their patients almost all day. If you’re noticing that anxiety is causing significant distress or anxiety is disrupting a patient’s ability to concentrate during medical conversations or decision-making—anytime you’re seeing significant distress or disruption to functioning, that’s a pretty good indicator that referral to a psychiatric nurse and psychiatric care could be very helpful for that patient,” Amber Altidor, DNP, APRN-FPA, PMHNP-BC, assistant professor at Rush University College of Nursing and psychiatric nurse practitioner...
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Episode 433: Cancer Treatments for Noncancer Indications: Chemotherapy/Immunotherapy
The ONS Podcast
“Unlike our cancer indications where we use these medications often to activate the immune system to target cancerous cells, in noncancer indications, the goal is really to either suppress an overactive immune or inflammatory cells or modulate the immune system. Immune modulation by use of chemotherapy and immunotherapy can help reduce abnormal inflammation, decrease autoantibody production, and also can alter T-cell and B-cell activity,” ONS member Kelsey Miller, MSN, RN, AGCNS-BC, OCN®, clinical nurse specialist in oncology and infusion therapy at Reading Hospital in West Reading, PA,...
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Episode 432: Long-Term Chronic Lymphocytic Leukemia Considerations for Oncology Nurses
The ONS Podcast
“It’s a chronic disease. It never goes away for some people, and so therefore it has these periods of remission where it’s really quiet and well controlled. Then there can be periods of flares where you’re actively engaged in treatment or it’s impacting other pieces. There’s this feeling patients have of, ‘When am I going to have that flare?’ You know, this anticipatory anxiety of, ‘When are things going to be done differently?’ or ‘When do I need to change?’” ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer...
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Episode 431: Oncologic Emergencies 101: Urinary Obstruction
The ONS Podcast
“Think about all the important things our kidneys do for the body. Those things are compromised. If we have excess buildup of toxins and waste in the body, you’re having problems with fluid reabsorption. Then you have also problems with electrolytes not being balanced. Then in turn, you have ongoing shutdown of systems. So the cardiopulmonary system gets compromise. Your circulatory system then gets compromised. And then all the things in the body that depend upon ongoing circulatory flow are then causing major resets in the system that need to be addressed,” ONS member Brenda S....
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Episode 430: Leadership Unlocked: Is It Your Time to Serve?
The ONS Podcast
“If you are considering board service, I would say take the leap. Start with your local chapter. It will give you some valuable skills that will help prepare you when you are applying for your national level. And I always say, if you want to do it, just do it because what’s the worst that can happen? They can say no, but that doesn’t mean that you will never serve on a board. I always tell people delayed is not denied,” Cassandra Green, DNP, RN, OCN®, ONS member and past president of the Oncology Nursing Certification Corporation (ONCC) Board of Directors, told Evelyn Wempe, DNP,...
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Episode 429: Radiation Site-Specific Side Effects: CNS Cancers
The ONS Podcast
“They’re really worried that radiation is going to be painful. So they come in for that first day of treatment very anxious. With our patients with brain cancer, we’re using the masks on the table, and those masks are very tight and hold their heads very, very still. So they’ll be very worried about being claustrophobic. We may start out the first day or two with a little bit of [lorazepam]. And they’ll come to me and they’ll say, ‘This really hasn’t been as bad as I thought it was going to be,’” ONS member Catherine McCluskey, BSN, RN, OCN®, ROCN™, radiation oncology...
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Episode 428: Chronic Lymphocytic Leukemia Treatment Considerations for Oncology Nurses
The ONS Podcast
“Measurable residual disease is where I think the terminology fits best in that, it is intended to measure the amount of cancer cells that are present in the blood or bone marrow at the time the sample was collected. We can identify one cancer cell in a million. Where that can be really valuable is when we start to think about the duration of treatments and the response to some of our treatments,” ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer Institute in Boston, MA, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical...
info_outline“I think poor discharge planning is that top contributor [to readmission]. And by that, I mean discharge planning that doesn’t assess a patient’s educational level, their support at home, what resources they have, like transportation and finances, and then to go further, evaluating if the patient even understand the reason they were admitted and then how to manage their care once they leave. There’s only so much we can treat in the hospital. what happens at home is what we need to prepare our patients for,” Stephanie Frost, MN, RN, OCN®, manager of outpatient clinics at City of Hope Cancer Center Chicago in Illinois, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about preventing hospital readmissions in patients with cancer.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
Learning outcome: Learners will report an increase in knowledge related to nursing strategies to reduce readmission rates for patients with cancer.
Episode Notes
- The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast episodes. Find a full list of opportunities.
- Oncology Nursing Podcast episodes:
- ONS Congress® presentations:
- ONS Voice articles:
- Cross-Discipline Cancer Care: Oncology Nurses Share Specialized Knowledge With Non-Oncology Settings
- Postdischarge ICI Patient Education Eliminates Hospital Readmissions
- Symptom Management Strategies You May Not Be Using
- Transitions in Care: Communication Builds a Bridge of Consistent Support for Patients
- ONS books:
- Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
- Telephone Triage for Oncology Nurses (third edition)
- ONS courses: Treatment and Symptom Management—Oncology RN
- Clinical Journal of Oncology Nursing articles:
- Oncology Nursing Forum articles:
- ONS Huddle Card: Handoff Communication
- ONS Guidelines™ and Symptom Interventions
- Healthy People 2030: Social Determinants of Health
- Journal of the Advanced Practitioner in Oncology article: Uncovering and Addressing Implicit Bias in Oncology
To discuss the information in this episode with other oncology nurses, visit the ONS Communities.
To find resources for creating an Oncology Nursing Podcast™ Club in your chapter or nursing community, visit the ONS Podcast Library.
To provide feedback or otherwise reach ONS about the podcast, email [email protected].
Highlights From This Episode
“Of course readmissions are inevitable, but ultimately, high rates may indicate that there’s a problem. Something is wrong. The quality of our care is not up to par. So looking at the rate of unplanned readmissions encourages hospitals to look inward, to see what’s going on, and find the gaps.” TS 2:31
“The number one thing we can do is review the patient’s social determinants of health. We’re seeing this assessment tool used more and more in the hospital system, and it can truly help identify high-risk patients. … But it really takes into consideration a patient’s environment, and it includes five components—access and quality of education, economic stability, healthcare access and quality, home environment, and then the patient’s community.” TS 5:17
“Recently, we had a patient that was seen in our ED [emergency department] for nausea and vomiting. And then due to that follow-up call the nurse made, she was able to get another set of labs drawn on the patient, found that they had an electrolyte imbalance, and then got the patient set up for fluids in an outpatient setting. So I think that really prevented that patient from going back to the ED, probably for the same reason they were there in the first place.” TS 18:00
“When we reviewed the data, we saw our readmission rates had dropped by 51% at the six-month mark, and same with our ED visit rates. And then our referrals to the continuous care team jumped 155%. … But we were able to discover some other opportunities through the process. So for example, through the chart audits completed, we were able to identify an increased need for our pain management services. There was a large number of patients that the reason for visit was pain, so we ended up expanding our templates for our pain management providers to meet that need and ultimately reduced the admissions for pain.” TS 22:38