Neurotoxicity is a serious problem affecting both the quality of life of cancer patients and the very possibility of antitumor intervention. A large group of modern highly effective cytostatics, including Cytarabine, induce clinically significant symptoms of neurotoxicity which may require modification of doses, delays in treatment cycles, and even termination of intervention (Szoch & Kaiser, 2015). Unlike most of other complications associated with chemotherapy, the clinical manifestation of neurotoxicity is usually subjective. Evaluation of the severity of neurological impairments remains very conditional to date and largely depends on the experience of a health practitioner.
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Since the adequacy of patient assessment and, consequently, the outcomes of chemotherapy depend on the level of practitioners’ competence and knowledge, it is recommended to develop a tool for the analysis of doctors and nurses’ neurotoxicity assessment skills, as well as behavioral guidelines and protocols (Visovsky et al. 2012). Additionally, as the innovation for the project aimed at the design of new neurological assessment tool for patients receiving high doses of Ara-C, it can be suggested to include the preliminary patient assessment with the purpose of health risk identification and prevention.
By obtaining relevant information before the development of complications, health practitioners may reduce possible biases and increase treatment effectiveness. Therefore, it may be considered that the combination of compliance with comprehensive patient assessment protocols with the application of preliminary evaluation tool may help reduce Cytarabine-induced neurotoxicity rates.
Diffusion of Innovation: Importance
According to Rother (2014), communication of research findings should be conducted in such a way that allows a lay audience, including decision-makers, stakeholders, and the general public, to implement information in risk management. Diffusion of innovation usually occurs in two major steps: communication of objective information (i.e., research evidence) and evaluation of innovation by those who already adopted it. It is possible to say that the second phase is especially important as it may verify the value of innovation and objective study findings and, in this way, accelerate and facilitate the diffusion process.
Communication of research results and innovation through publications in professional and academic journals or online media, including professional forums and websites, is of great importance because even if readers may not be interested in innovation as such, by having access to this information and reading about it, they may develop awareness of possible solutions for the improvement of adverse situations. As stated by Pashaeypoor, Ashktorab, Rassouli, and Alavi-Majd (2016), the knowledge of a particular practice increase the likelihood of the adoption of EBP. For this reason, it is important to disseminate information through appropriate communication models. In the case of the present clinical research project, the publication in a highly credible source can reaffirm the quality of proposed innovation.
Significance of Project Results
Nowadays, no unified standards related to the correction of Cytarabine-induced neurological complications can be found in contemporary literature. To date, researchers have investigated various drugs (e.g., tissue metabolism improving agents, calcium channel blockers, corticosteroids, analgesics, etc.) as potential neuroprotectors. Some of them demonstrated promising results and still data collected from randomized trials does not confirm the effectiveness of these agents (Beijers, Jongen, & Vreugdenhil, 2012). Moreover, the intervention of neurological disorders in oncological patients usually begins when the deterioration in the quality of life becomes severe. Therefore, the prevention of neurotoxicity is preferable.
It is possible to say that the results of the project are worth disseminating through a larger venue beyond the selected facility because of the large scope of the problem. According to statistical data, there are 28 million cancer survivors worldwide (Park et al., 2013). Thus, the issues related to post-chemotherapy recovery and quality of life of patients are topical especially because chemotherapy-induced peripheral neuropathy may lead to “permanent symptoms and disability in up to 40% of cancer survivors” (Park et al., 2013, p. 420).
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The results obtained through the examination of the new neurological assessment tool can be published in such periodicals as Journal of the Advanced Practitioner in Oncology or Clinical Journal of Oncology Nursing because they are the recognized journals for practitioners and graduates. They provide recent information on a great variety of oncology-related topics, and articles published in the editions can be characterized as progressive and innovative.
In case the grant is received, it will be appropriate to start the research from identifying all possible risk factors contributing to chemotherapy-related neurological complications. A few of these contributing factors include the presence of anti-Hu and Anti-CV2 antibodies in patients, as well as hematological malignancies which may cause large- or small-fiber nerve dysfunctions (Park et al., 2013). It is also possible to investigate environmental risks and drug-induced risks.
The given objectives can be achieved through the collection and analysis of relevant research evidence. The results of the systematic literature review may then be used to design self-assessment and knowledge assessment tools for practitioners − it will be the second stage of the research process in the project. It will allow the identification of learning needs and support the development of both behavioral protocols for health providers and the tool for the preliminary assessment of risks for the development of neurotoxicity in patients.
Visovsky et al. (2012) state that the use of assessment guidelines including step-by-step examination and physical assessment handouts, as well as repeated training practices, significantly contribute to the feasibility and effectiveness of patient examinations. Therefore, it can be recommended to identify possible gaps in practitioners’ knowledge and skillfulness in order to reduce biases during the evaluation of proposed patient assessment tool at later stages of project completion.
Beijers A. J., Jongen J. L., & Vreugdenhil G. (2012). Chemotherapy-induced neurotoxicity: The value of neuroprotective strategies. The Netherlands Journal of Medicine, 70(1), 18-25.
Park, S. B., Goldstein, D., Krishnan, A. V., Lin, C. S., Friedlander, M. L., Cassidy, J.,… Kiernan, M. C. (2013). Chemotherapy-induced peripheral neurotoxicity: A critical analysis. A Cancer Journal for Clinicians, 63(6), 419-437. Web.
Pashaeypoor, S., Ashktorab, T., Rassouli, M., & Alavi-Majd, H. (2016). Predicting the adoption of evidence-based practice using “Rogers diffusion of innovation model.” Contemporary Nurse, 52(1), 85-94. Web.
Rother, H. (2014). Communicating pesticide neurotoxicity research findings and risks to decision-makers and the public. NeuroToxicology, 45, 327-337. Web.
Szoch, S., & Kaiser, K. S. (2015). Implementation and evaluation of a high-dose Cytarabine neurologic assessment tool. Clinical Journal of Oncology Nursing, 19(3), 270-272.
Visovsky, C., Haas, M., Faiman, B., Kurtin, S., Shaftic, A. M., Lyden, E., & Rice, J. (2012). Nurse self-evaluation of assessment of chemotherapy-induced peripheral neuropathy in patients with cancer. Journal of the Advanced Practitioner in Oncology, 3(5), 319–325.