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Cervical Cancer: Nursing Research and Evidence-Based Practice

Abstract

Nursing is one of the few careers that are not only based on the passion to save lives but also on a calling to serve humanity. Therefore, nurses are very important in our lives as humans. Therefore, Evidence-based Practice (EBP) means the exploration and use of the best available and research-proven treatments in nurses’ daily routines. Nurses are required to keep up with the developing medical practices and the advancements in technology. There are many different alternatives that can be used in the management of cancer cells and particularly cervical cancer cells in women. Several researchers argue that the use of the annual cervical cancer screening procedure is more harmful and its benefits are undermined by the risks involved. This essay seeks to discuss the annual cervical cancer screening practice to identify the EBP that can be used to replace it.

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Introduction

My patient care practice of interest in this EBP research is the annual cervical cancer screening. This practice had been in existence for long before other options were discovered. However, scientific proof has shown that the annual screening is causing more harm than benefits to patients. The issue of screening women for cervical cancer on a very frequent basis is a health risk rather than a treatment procedure. The major risk of cervical cancer screening on a yearly basis is the psychological trauma created by the screening results. During the screening process, a number of cytological irregularities may be detected (Katki, Kinney, Fetterman, Lorey, Poitras, Cheung, & Castle, 2011).

Such abnormalities include atypical Squamous cells and Low-grade Squamous Intraepithelial Lesions (Centers for Disease Control and Prevention, 2013). Such sales as research has shown do not progress to cervical cancer. Nonetheless, their detection causes anxiety in women and may lead to unnecessary follow-up tests and eventually treatment for cancer cells that are not present in the cervix. There is also the risk of misleading negative results hence leading to the advancement of the cancer cells. To avoid such risks, it is important that the nursing fraternity adopts a new practice to treat cervical cancer issues.

How change would differ from the current practice

First of all, the current process of screening is a yearly practice that comes along with a myriad of other harms. These harms weighed against the benefits of annual cervix cancer screening make the practice unworthy. As suggested by most researches on this issue, the period of screening should be extended to every three years for women under the age of 30 (Massad, Einstein, Huh, Katki, Kinney, Schiffman, & Lawson, 2013). Researchers have agreed that it is safer to have the screening done less frequently and three years are the recommended period gap. While the current practice involves screening for cancer cells, other EBP is available (Massadet al., 2013).

One of the recent EBP is the target therapy procedure. Information about the gene alterations in the cells that cause cancer has led researchers to discover a better way of dealing with cervical cancer (Saslow, Solomon, Lawson, Killackey, Kulasingam, Cain, & Myers, 2012). They have developed a new drug that is specifically meant to target the changes in this cells. This drugs act in a different way from the usual chemotherapy medication (Saslow et al., 2012). This drug inhibits the certain growth factors in the cancer cells hence reducing its ability to spread (Saslow et al., 2012).

Significance of change to nursing

A change in the current practice is very significant to nursing because it changes the results achieved and consequently their reputation. The nursing profession suffers great harm in terms of reputation when a bad diagnosis is carried out. It becomes even worse when such a medical error leads to death or other calamitous implications. In this case, it has been scientifically proven that false positive or negative results are possible. This may lead to treatment when there is no need for it or non-treatment when a patient requires it (Katki et al., 2011).

The confusion in the results from an annual screening test can deny a patient the opportunity to receive treatment in the early stages of the cancer cells’ formation if the negative results were wrong. A change in the current practice to the new and EBP can easily redeem the profession from a negative public perception.

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Alternatives used to compare ad evaluate

Several alternatives to annual cervical screening for cancer include Sentinel Lymph Node Biopsy, HPV Vaccines, hyperthermia, and drug treatment of pre-cancer (American cancer society, 2014).Sentinel Lymph Node Biopsy involves removing lymph node to check if the cancer cells have spread (American cancer society, 2014). However, this is different from the normal surgical process. In this practice, only a few lymph nodes are targeted and these are the most likely nodes to have cancer cells (American cancer society, 2014). The smaller the quantity of lymph nodes removed the slighter the probability of later problems.

HPV vaccines are vaccines developed to block infection from the HPVs that are known to breed cervical cancer cells. Such vaccines are meant to give the body the immune power to fight off HPV types 16 and 18 (American cancer society, 2014). This facilitates prevention of contamination to women who are exposed to the HPV virus types that cause cancer (American cancer society, 2014). In addition to the preventive functions of the HPV vaccines, they also can help in boosting the immune systems of already infected women. The vaccine destroys the virus inside the curing the infection in time before it develops to cancer (American cancer society, 2014). Hyperthermia on the other hand is a process of killing the cancer cells and ensuring that they do not replicate or come back again.

This helps the patient to prolong his or her life. The process is a heat to raise the temperature around the tumor to destroy the cancer cells. Lastly, drug treatment of pre-cancers such as Cervical Intraepithelial Neoplasia involves laser treatment and conization (American cancer society, 2014). Research shows that drug such Diindolylmethane and Cidofovir were successful in treating CIN completely (American cancer society, 2014).

Evidence-bases augment for selected changes

A change from the annual cervical cancer screening to a better practice like the HPV Vaccine or the 3 years gap suggested by researcher is the best move for nursing. These practices give more accurate and better preventive measures compared to the current practice. This change will improve patience response to treatment and also it will significantly reduce the risks of other complications.

Conclusion: A plan to initiate change

First and foremost in order to have a successful transition from the current practice to the alternative practice the nurses must be trained on the new procedures. This involves updating the nurses’ skills in order to achieve good results. In order to function better, the nurses on the other hand must inform the patients about the new procedure and allow him or her to choose their preferred one. This will greatly enhance a smooth transition from the current practice to the new one. For quality care to be realized, the process must be gradual and not abrupt. Patients should be considered and their response to a treatment plan can highly compromise the effort to introduce a new process.

References

American cancer society: Treatment options for cervical cancer, by stage, (2014). Web.

Centers for Disease Control and Prevention. (2013). Cervical cancer screening among women aged 18-30 years-United States, 2000-2010. Morbidity and mortality weekly report, 61(52): 1038.

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Katki, H. A., Kinney, W. K., Fetterman, B., Lorey, T., Poitras, N. E., Cheung, L., & Castle, P. E. (2011). Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a population-based study in routine clinical practice. The lancet oncology, 12(7): 663-672.

Massad, L. S., Einstein, M. H., Huh, W. K., Katki, H. A., Kinney, W. K., Schiffman, M., & Lawson, H. W. (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstetrics & Gynecology, 121(4): 829-846.

Saslow, D., Solomon, D., Lawson, H. W., Killackey, M., Kulasingam, S. L., Cain, J., & Myers, E. R. (2012). American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. A cancer journal for clinicians, 62(3): 147-172.

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