Episode 322: Nursing Strategies to Reduce Readmission Rates for Patients With Cancer
Release Date: 07/26/2024
Episode 411: An Overview of Myelodysplastic Syndrome for Oncology Nurses
The ONS Podcast
“Not every patient with myelodysplastic syndrome (MDS) is going to progress and die. Only 10%–20% of them will evolve into acute myeloid leukemia. And not all of them need blood transfusions. Some present with low platelet count. It’s not just people who are anemic that have MDS—it’s different depending on what type of MDS they have. These are averages. We’re giving you statistics based on averages, and you’re an individual, so we want to treat you as an individual,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt...
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Episode 410: The Evidence for the Environment’s Impact on Cancer Outcomes
The ONS Podcast
“Cancer and environmental disasters in particular, but the worsening of our environment, are really things that are great equalizers. And we recognize that we’re all kind of in this world together. We can really face these issues on a more human level. I think always recognizing that if we look at something, we think, ‘Well, that doesn’t relate to me or that problem is it really isn’t my problem’—it sure is,” ONS member Margaret “Peggy” Rosenzweig, PhD, CRNP-C, AOCNP®, FAAN, ONS scholar-in-residence and distinguished service professor of nursing and Nancy Glunt Hoffman...
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Episode 409: An Overview of Interventional Oncology for Nurses
The ONS Podcast
“Interventional oncology has really evolved into an important component of modern cancer care and is often described now as the fourth pillar alongside medical, surgical, and radiation oncology. The specialty now encompasses a broad spectrum of image-guided procedures that support from cancer diagnosis, treatment, to effectively managing symptoms that are caused by the disease. In other words, what we’re seeing is that across the continuum of care, IO is playing a vital role,” ONS member Evelyn P. Wempe, DNP, MBA, APRN, ACNP-BC, AOCNP®, CRN, NEA-BC, executive director for advanced...
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Episode 408: Radiation Site-Specific Side Effects: Breast Cancer
The ONS Podcast
“A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It’s quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it’s throbbing or heavy. Clothing may not fit quite right. So we’re always on the lookout for lymphedema,” Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice...
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Episode 407: Pharmacology 101: CAR T-Cell Immunotherapy
The ONS Podcast
“You want to try to act quickly and be able to know what the pathways are for appropriate escalating when a patient is having symptoms that are reflective of cytokine release syndrome (CRS) or neurotoxicity. These toxicities are very manageable and treatable when recognized early. To summarize, choosing the right patient, knowing the toxicity profile for each product, and acting early is really what helps to prevent severe outcomes with chimeric antigen receptor (CAR) T-cell therapy,” Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center at...
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Episode 406: Drug Resistance Biomarkers and Their Impact on Cancer Treatment Choices
The ONS Podcast
“Our goal of precision oncology has been to shift to tailored therapies that can help to improve treatment efficacy and ultimately improve patient outcomes. Resistance biomarker testing can help the care team to detect these genomic changes that the tumor may have acquired during therapy that makes the cells resistant to therapy. This information can be extremely helpful when we’re talking about making choices about second-line or subsequent-line therapy,” ONS member Danielle Fournier, DNP, APRN, AGPCNP-BC, AOCNP®, advanced practice RN at the University of Texas MD Anderson Cancer...
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Episode 405: Long-Term Multiple Myeloma Considerations for Oncology Nurses
The ONS Podcast
“The disease is increasingly managed as a chronic condition rather than a diagnosis with an immediate terminal outcome. Particularly, with earlier and more effective and sustained treatment options, we can make this disease a very chronic, long-term, livable condition. I want to make sure that patients are aware that this is not a death sentence. This is something that patients can live with for the long term,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS®,...
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Episode 404: Tailor Patient Treatment Education for Non-Oncology Indications
The ONS Podcast
“We print education sheets that we have, and we say, ‘Just ignore this part that says cancer. You’re getting this med but for a different indication.’ And then you have to really point out what our goals of care are. You’re using the information that, as oncology nurses, we like and love, but we’re having to cross it out and say, ‘Just read this portion and just do this here.’ And that can be challenging for the nurse and probably confusing for the patient,” ONS member Brandy Thornberry, RN, OCN®, outpatient infusion and VAD supervisor at Logan Health in Kalispell, MT,...
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Episode 403: Pharmacology 101: Checkpoint Inhibitors
The ONS Podcast
“Because the premise of immune checkpoint blockade centers around elevating the immune function, we should always take a great deal of caution around those patients who have high immune risks. Those include patients with autoimmune disorders. That’s one of our biggest questions that we ask, usually every consult that we’re seeing with solid tumor. ‘Do you have any history of autoimmune disorders? Tell me a little bit more about it. Is it being treated? What are your symptoms like?’ And then also patients who have undergone organ transplants. Now, interestingly, this does include stem...
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Episode 402: Radiation Site-Specific Side Effects: Head and Neck Cancer
The ONS Podcast
“It’s important to clarify that most patients will experience and at least some side effects—and often several. So prevention really means reducing severity, complications, and long-term impact rather than avoiding side effects altogether. This process starts before radiation begins and continues throughout the treatment and includes dental evaluation, baseline swallowing assessments, and thorough patient education,” ONS member Astrid Amoresano, RN, OCN®, lead oncology nurse specialist at New York Proton Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager...
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 pubONSVoice@ons.org.
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