Date of Graduation

Fall 12-14-2012

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

Department/Program

Nursing

First Advisor

Judith Lambton

Second Advisor

KT Waxman

Third Advisor

Sandra Skettino

Abstract

The translation of advances in clinical research into clinical practice in a manner that provides benefits while reducing potential harm is a challenge within the health care delivery system. Data from a phase III multicenter clinical trial led to the 2012 US Food and Drug Administration (FDA) approval of a 90-minute infusion of rituximab (Rituxan) starting at Cycle 2 for patients with non-Hodgkin’s lymphoma who did not experience a Grade 3 or 4 infusion-related adverse event during Cycle 1. The 90-minute rituximab faster infusion will result in a significant change in how nurses in the United States have been administering rituximab since initial FDA approval 15 years ago. This innovative change and its potential impact on patient care demonstrates the need for evidenced-based approaches that integrate the best current knowledge of rituximab administration with nursing clinical expertise to help ensure safe and effective resource utilization when delivering patient care. The aim of this Doctor of Nursing Practice project is to develop an evidenced-based tool kit to assist oncology nurses in adopting rituximab faster infusion while maintaining patient safety, achieving benefits in resource utilization, and promoting both patient and nursing satisfaction. A review of the literature was conducted to identify existing data and a tool kit was created to enable oncology nurses to conduct 30-day pilots to assess the real-world impact of rituximab faster infusion on nursing practice, patient safety, and resource utilization. An interdisciplinary panel of rituximab experts evaluated the clinical accuracy and overall usefulness of the tool kit and confirmed that components were clinically accurate and could inform the adoption of rituximab faster infusion by oncology nurses.

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