NURSING IN ONCOLOGY

Course Sheet

Course code:

IN22B4D

Academic Year of enrolment:

2022

Year of supply:

2023/2024

Divisions:

CANALE A

Type of Course:

Characterising

Degree:

Course of 1st Cycle Degree in NURSING

Disciplinary Sector:

General, Clinical and Pediatric Nursing

Is part of:

NURSING IN ONCOLOGY

Location:

PESCARA

Credits:

Programme Year:

Professor and Collaborators:

DIODATI ANTONELLA

Cycle:

Second semester

Obligatory attendance:

Yes

Hours of classroom activity:

Individual study hours:

Prerequisites:

Having taken and passed the exams of the Integrated Course of Nursing Sciences in the Medical and Surgical Area and the Integrated Course of Nursing Sciences in specialist and integrated medicine

Objectives

Specific training objectives and expected skills

EXPECTED LEARNING OUTCOMES

Knowledge and understanding
- Identify the role of prevention and education aimed at the person and caregivers in promoting healthy lifestyles.

- Describe the epidemiology of tumors and the relationship between known risk factors and the probability of onset of the main neoplasms

- Explain the methods, timing, effectiveness/usefulness and expected results of screening (also in relation to individual risk) for breast, cervical, colorectal and prostate cancer;

- Know and understand the meaning and relative clinical use of tumor markers and the main blood chemistry tests

- Describe the criteria for defining tumor staging, the meaning and usefulness of prognostic and predictive factors

- Synthesize one's knowledge in clinical and nursing sciences by indicating strategies for prevention, early identification and management of health problems of patients with onco-haematological problems.
Ability to apply knowledge and understanding
(Applying knowledge and understanding)
- Ascertain, describe and evaluate the effectiveness of strategies:
 coping for the purposes of adapting to the neoplastic disease
 of self care adopted by the person.

- Activate prevention and education strategies for the person and caregiver to enhance adherence to healthy lifestyles and screening programs, with particular attention to subjects at risk of breast, colorectal and prostate cancer
- Recognize the characteristics of the symptoms that may suggest the presence of a neoplasm for the purposes of early diagnosis: pain, cough, dysphonia, dysphagia, bowel disorders, hemorrhages, neurological symptoms;

- Recognize the phases of the neoplastic disease, the meaning of the various therapeutic interventions including supportive ones, indicating the intentions and objectives of oncological treatments and their impact on survival and quality of life;

- Recognize the general criteria underlying the therapeutic decision-making process in onco-hematology: mode of action of anticancer drugs (chemotherapy, hormone therapy, molecular targeted therapies), evaluation of therapeutic benefit (response criteria and definition of endpoints), main side effects anti-tumor drugs and intervention strategies for their management; rationale of the main oncological surgery interventions and integration with other therapeutic modalities; oncological indications of radiotherapy and integration with other therapeutic interventions;
- Describe the haematological clinical pictures (acute myeloid and lymphoid leukemias, lymphomas), the main critical care issues and the nursing strategies for routine and personalized management;

- Recognize the therapeutic strategies with the greatest impact for the patient and care in hematology (cell therapy, innovative therapies) and the relevance of the nursing contribution in effective transplant procedures;

- Activate the main palliative care strategies and techniques for the management of patients with advanced onco-haematological problems;

- Pain management; Law no. 38; use of stairs;

- Understand the culture and care model of palliative care and the criteria for remodulating nursing interventions in end-of-life care; the D.A.T.;

- Recognize the stages of dying and the stages of re-elaboration of the patient's (and his family's) mourning for the loss of body image, role functions and hope of recovery and activate strategies to accompany the patient in the terminal phase;

Transversal skills (Soft skills):
Making judgments
- Demonstrate ability to:
 analysis (definition of the nursing diagnosis)
 formulation of objectives
 definition of care interventions, identification of expected outcomes with respect to the main diagnostic frameworks
of the patient with oncological pathology and
haematological
 identify and describe skills
specifications and behaviors
assistance for people affected by
oncological and hematological pathologies

- define the fundamental aspects for the management of the transplanted patient (bone marrow transplant)

- intervene in the management of exposure of the operator and the environment to antiblastic drugs and in the case of extravasation into the person

- ascertain, intervene and monitor the effects of nursing interventions in patients with the most frequent onco-haematological problems: mucositis, constipation, diarrhoea, asthenia, fatigue, altered nutritional conditions, alteration of body image, immunosuppression
- ascertain psycho-social needs, sources of stress and self-care strategies in the peri-diagnostic and therapeutic phase to better support the person and family in adhering to treatment and adapting to the neoplastic disease

- use adequate multidisciplinary pain assessment tools with particular attention to total pain

- propose, on the basis of the clinical pictures treated, the therapy, the complications and the risks, as well as the patient's therapeutic path, the care plan relevant to care situations of an onco-haematological nature of medium complexity.

Communication skills
- Master the appropriate terminology for effective nursing communication in the oncology-hematology field

Learning skills
- Plan and manage individual study in preparation for the exam

Contents

Know, analyze and interpret the problems of people affected by cancer in the various phases of the pathological process, from treatment to the advanced stage of the disease
Know the methods of administration of antineoplastic treatments
Know the contribution of research to oncology nursing.
Know the different contexts in which onco-haematological care is provided.
Plan evidence-based nursing interventions for the treatment and prevention of symptoms and complications resulting from cancer treatments
Know the approach to the terminally ill.
Know how to plan care for patients with oncological and hematological problems, from their onset, in the different emotional, social and clinical stages of the disease, and in the different treatments proposed.
Know the approach to the patient in palliative care,
Know the final stages of life and care needs.

Extended Syllabus

Prevention in the population at risk
Screening principles and risk factors. The European Recommendations for the prevention of cancer. Prevention and early diagnosis strategies. Nursing role in early diagnosis for subjects at risk (breast, colorectal, prostate cancer).
Management of patients with neoplastic disease
The assessment of the personal coping style and the factors that influence it during the illness.
Coping strategies that help the patient deal with the disease:
• social (multidisciplinary treatment team, family and caregivers, self-help groups, parental network, volunteering);
• cognitive (reinforcement of information on the disease and treatment plan, problem solving);
• self-care (management of aids, therapeutic and side effects of antiblastic therapy)

Assistance in the oncology-hematology field – application of the clinical method
Frequent problems related to the pathology and treatments (chemotherapy and radiotherapy): Anorexia/hypophagia, mucositis, nausea/vomiting, constipation/diarrhoea, Chronic Fatigue Syndrome.
Using the phases of the clinical method to:
• Formulate appropriate diagnoses;
• Identify the prognostic aspects of the case;
• Define patient-specific goals and objectives
appropriate care interventions;
• Identify expected patient outcomes
Specific methods and tools for ascertaining the most frequent healthcare problems:
• General framework and quality of life (K.P.S.; QLI - Quality of Life Index);
• Fatigue (F.A.S.);
• Nutritional Status (M.U.S.T., M.N.A.);
• Oral cavity alterations (WHO Oral Toxicity Scale);
• Pain (NRS, VAS, Wong Baker, PAINAD, NOPPAIN, EVENDOL, BPS, PIPP, FLACC, CHEOPS, CNPI, Abbey Scale, CPOT, P.Q.R.S.T. System, S.O.C.R.A.T.E.S.).
Nursing management of symptoms and side effects related to proposed pharmacological treatments.
Management and treatments of patients suffering from onco-haematological pathology with:
• Altered nutritional conditions;
• Mucositis;
• Constipation and diarrhea;
• Asthenia and Fatigue (RCFS – Related Cancer Fatigue Syndrome);
•Ache;
• Alterations in body image;
Prevention and control strategies for complications in patients suffering from haematological pathologies:
• Management of immunosuppressed patients (neutropenic infections); Systemic infections/Sepsis/Septic shock, V.O.D.;
• Management of patients at risk of bleeding.
• Marrow transplant: care priorities in the different phases (pre, post transplant and follow up). Management S/S CSE transplant (GvHD); Therapeutic education of users and care givers;
Protective isolation: aspects of management and patient support; Therapeutic education of users and care givers; hospitalizations with low microbial load;
Management S/S CAR T infusion; Therapeutic education of users and care givers;
Methods and tools for managing risks related to chemotherapy and radiotherapy treatments
The approach and management of the patient undergoing radio/chemotherapy treatment:
• Measures in the management of chemotherapy (handling, preparation and administration phases);
• Individual (patient and operators) and environmental protection measures;
• Aspects of patient management in case of extravasation of chemotherapy drugs (Definition of extravasation (Oncology Nursing Society);
• Risk factors associated with extravasation;
• Classification of antiblastics and tissue damage;
• Symptoms of extravasation;
• Treatment of extravasation lesions;
Aspects of management of the radiotreated patient prevention and treatment of radiodermatitis and alterations of the mucous membranes and digestive tract

Recommended Bibliography

Janice, Hinkle, Kerry, Cheveer, 2017, “Brunner Suddarth; Infermieristica”, Ambrosiana;
Gulanick, Myers, 2016, “Piani di assistenza infermieristica, diagnosi infermieristiche, risultati di salute ed interventi infermieristici”, Casa Editrice Ambrosiana;
Ravaioli, 2010, “Manuale di oncologia per infermieri”, Il Pensiero Scientifico;
Turrizani, Zaninetta, 2018, “Il mondo delle cure pallliative”, Esculapio;
Guidelines: GITMO, IARC, ONS, AIOM, RNAO AEIOP, ADMO, SICP, EAPC, IASP, ASPMN, NCCN, Ministero della Salute.

Teaching Methods

The course will be carried out through interactive frontal lessons with the aid of iconographic material in Power Point files for a total of 2 credits equal to a total of 30 hours.
Theoretical knowledge will be acquired through attendance at lessons, integrated with the study of texts and L.G. recommended.

Evaluation methods

Verification of learning:

The student must demonstrate that he has acquired sufficient knowledge:
- importance of onco-haematological nursing
- common signs and symptoms of cancer and how early diagnosis affects morbidity;
- On the administration of anticancer therapies in a safe and effective way
- the principles and application of commonly used therapeutic modalities;
- the principles of health and safety protection, including radiation protection, disposal of cytotoxic drugs, infection control and basic emergency procedures;
- importance of health literacy for users and caregivers.
The learning assessment is based on an oral test.
The evaluation is expressed in thirtieths; the exam is passed if the evaluation is equal to or higher than eighteen out of thirty (18/30) in all the teaching modules of which it is composed. A grade lower than 18/30 in one of the modules entails repeating the exam.
The assessment of insufficiency is not accompanied by a grade.
Honors can be granted unanimously, if the final mark is thirty.

Contacts/More Information

The publicity of lesson times and teaching programs is ensured by the CdS and University websites. The appeals are indicated on the ESSE3 application.

Università degli Studi
"G. d'Annunzio"

Chieti - Pescara

Aree