Research and Scholarship

Assessment of Oncology Provider Knowledge and Cardiovascular Screening Practices: A Call for Heightened Screening

Katherine Albert,(1) DNP, FNP-BC, AOCNP®, Deborah Pollard,(1) PhD, RNC-OB, CNE, IBCLC, Jennifer Klemp,(2) PhD, MPH, MA, Lavanya Kondapalli,(3) MD, and Deborah Tuffield,(1) DNP, FNP-C, CCRN

From (1)Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences, University of Colorado at Colorado Springs, Denver, Colorado; (2)KU Medical Center, The University of Kansas, Kansas City, Kansas; (3)University of Colorado Health Heart and Vascular Center, Denver, Colorado

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Katherine Albert, DNP, FNP-BC, AOCNP®, University of Colorado at Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918. E-mail: katherine.albert8@gmail.com

ABSTRACT

Cardiac risk factors are known to compound the development of cardiotoxicities (CTx) in patients exposed to anthracycline (ANT) chemotherapy agents. National oncology and cardiology organizations have published recommendations for cardiovascular risk stratification and screening cancer patients following exposure to ANTs. The frequency with which oncology providers are integrating these principles into practice is unknown. This knowledge-based quality improvement (QI) project was designed to heighten oncology provider competencies such that screening frequency of cancer patients for CTx in the post-ANT setting aligns more closely with national guidelines for care. A web-based educational intervention, cardiac screening tool, and evidence-based literature were shared with 20 oncology providers over the course of 5 months. Retrospective chart reviews and pre- and post-project surveys were performed to assess competencies and practice trends. Qualitative and quantitative data were analyzed to illustrate whether the interventions improved knowledge and changed practice. Findings revealed an increase in the number of provider-perceived percentage of high cardiac risk patients and the number of patients screened, knowledge did not improve, and the frequency by which oncology providers ordered echocardiograms increased minimally. Factors such as organizational system changes, time constraints, and change fatigue limited effective and consistent implementation of the project interventions. The trajectory of cancer survivorship is affected by cardiovascular disease. Cardiac screening of cancer patients is a critical component of cancer care that has the potential to positively impact economic and health outcomes of this susceptible population.

For access to the full length article, please sign in.