Do I have to vomit during chemotherapy? Shanghai New Pilot Program! The incidence of nausea and vomiting in this hospital's "nauseous ward" has decreased by 90%
2024-06-12 17:39:08
Chemotherapy is a common treatment for cancer patients, but the nausea and vomiting caused by chemotherapy make many cancer patients turn pale. In order to improve the medical experience of patients, the Oncology Department of Fudan University Affiliated Cancer Hospital has created a "nauseous ward" to reduce the incidence of nausea and vomiting in cancer patients during chemotherapy by 90%. Recently, the relevant management process was included in the 2024 version of the Shanghai Expert Consensus on the Full Process Management of Nausea and Vomiting Caused by Anti tumor Treatment. Can chemotherapy be more comfortable? The new pilot chemotherapy in 23 wards is a treatment method that suppresses or kills tumor cells through chemical drugs. Professor Guo Weijian, Chairman of the Cancer Rehabilitation and Palliative Care Committee of the Shanghai Anti Cancer Association and Director of the Department of Gastroenterology at Fudan University Affiliated Cancer Hospital, stated that some common chemotherapy drugs, such as platinum, doxorubicin, and fluorouracil, can have an impact on the human digestive system. Some patients may experience varying degrees of nausea and vomiting symptoms during treatment due to drug reactions or other factors. Professor Wang Biyun, Director of the Breast and Urology Oncology Department at Fudan University Affiliated Cancer Hospital, said that some patients have developed a rejection of chemotherapy due to nausea and vomiting, making subsequent treatment difficult to carry out. Therefore, the oncology ward medical staff joined hands to explore and carry out multiple clinical practices, hoping to reduce the adverse reactions of chemotherapy in cancer patients, and the "nauseous ward" emerged. As the only tertiary cancer specialist hospital in Shanghai, Fudan University Affiliated Cancer Hospital receives 217000 chemotherapy patients annually, including over 43500 inpatients undergoing chemotherapy. Effectively managing adverse reactions in chemotherapy patients, reducing the incidence of nausea and vomiting, is of great value in improving chemotherapy compliance in cancer patients and ultimately enhancing overall treatment outcomes. The director of the nursing department of the hospital, Lu Zhenqi, stated that in order to optimize the treatment experience of hospitalized chemotherapy cancer patients, the oncology medical team relied on the JBI Evidence Based Nursing Cooperation Center of Fudan University in 2015 to carry out the "Chemotherapy related Nausea and Vomiting" evidence-based nursing practice project, and gradually formed a "doctor nurse patient" joint participation mechanism. This work was first piloted in the 23 wards of Xuhui Hospital, aiming to improve the comfort of patients during chemotherapy. In the first batch of pilot wards in Shanghai, the effectiveness of "nauseous wards" has been remarkable. "The causes of chemotherapy nausea and vomiting include drug factors, as well as various reasons such as high psychological pressure or liver function damage during treatment. Many parts of the country are building" nauseous wards ", but the entire process management plan needs to be further improved." Yang Jian, the head nurse of the 23 wards in the Oncology Department, said that as the first batch of pilot construction wards in Shanghai for "nauseous wards", their medical team fully evaluated the individual characteristics of each patient when formulating the management process, divided the entire chemotherapy process into four stages, and subdivided the response strategies for different stages to form a chemotherapy full process management model. For example, when a patient is admitted to the hospital, the ward nurse will carry out phased dietary education. In the early stage of chemotherapy, risk screening and early prevention will be carried out, and evaluation tools will be embedded in the nursing medical record information system. Based on the screening results and the evidence-based medicine knowledge base designed by "non emetic specialist doctors", doctors prescribe preventive antiemetic medication plans. Nurses carry out personalized treatment nursing while implementing preventive antiemetic medication intervention. For example, for medium risk patients, strengthen self-management education on the environment and patients, such as oral hygiene and coping with taste changes; For high-risk patients, acupoint massage, aromatherapy, Five Elements music therapy, relaxation training, etc. are also combined to alleviate the occurrence of nausea and vomiting. Since the establishment of the "nauseous ward", the incidence of nausea and vomiting in high-risk patients has decreased by about 90%, and patient satisfaction and quality of life have also been significantly improved. In August 2023, the 23 wards of the Oncology Department of the Cancer Hospital were awarded the first batch of "National CINV (Chemotherapy Related Nausea and Vomiting) Standardized Management Demonstration Wards" in Shanghai. Yang Zhang stated that the "nauseous ward" of the internal medicine department of the tumor hospital has gradually formed seven characteristics, including adhering to evidence-based concepts and scientific guarantees; Implement risk stratification and precise strikes; A combination of Western and Chinese elements in the plan, with a dual approach; Full process management and comprehensive coverage; Multi disciplinary collaboration and joint progress; Technology empowerment and care upgrading; Community support and building a warm patient mutual aid network. "We will continue to optimize the workflow in the future." Lu Zhenqi stated that the hospital nursing team will further summarize the construction experience of "vomit free wards" and gradually promote it to all internal medicine wards and daytime chemotherapy. Professor Yu Xianjun, Dean of Fudan University Affiliated Cancer Hospital, stated that the establishment of the "nauseous ward" is based on the patient's medical experience, solving their actual problems. It not only focuses on disease treatment, but also on the quality of life of patients during the disease treatment process. "We hope that our medical team can continue to summarize experience, propose new strategies, and benefit more patients." (Xinhua News Agency)
Edit：Xiong Dafei Responsible editor：Li Xiang
Source：WHB
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