Taking Matters into Our Own Hands: Reeducation of Acupressure for Chemotherapy-Induced Nausea & Vomiting

Wednesday, July 13, 2011: 8:50 AM

Curt B. Haase, RN, BSN, OCN
Ambulatory Nursing, Memorial Sloan-Kettering Cancer Center, New York, NY

Learning Objective 1: The learner will be able to discuss the safe, well-tolerated, low-cost, effective nature of acupressure for chemotherapy-induced nausea & vomiting.

Learning Objective 2: The learner will be able to state the importance of reeducation of staff to ensure appropriate, evidence-based interventions for patients.

Purpose: Most chemotherapy patients report nausea & vomiting (NV) over the course of treatment. Historically, management of chemotherapy-induced NV (CINV) focused around pharmacologic antiemetics, though they are not entirely effective and are accompanied by undesirable side effects. Acupressure is safe, low-cost, easy-to-learn, convenient, and effectively combats CINV across healthcare settings, ages, and cancer diagnoses (Roscoe et al., 2010). Implementation by oncology nurses requires little time spent; however, acupressure is underutilized. The primary purpose is to ascertain the incidence of acupressure use for CINV by oncology nurses in an ambulatory chemotherapy infusion unit. Secondary purposes include identification of barriers oncology nurses face using acupressure with patients, as well as in educating patients and caregivers to incorporate acupressure into their daily activities.

Methods:  The nursing staff of an ambulatory chemotherapy infusion unit was educated in the purpose and technique of acupressure for CINV using the neiguan (P6) acupoint.  Informational fact cards were developed to support patient education. One year later, a nursing survey from the same unit assessed the frequency of acupressure use and the nurses’ beliefs and attitudes toward acupressure for CINV. The survey elicited barriers from the nurses and their perceptions of patient barriers.

Results: One year after initial staff education, only 38% of acupressure-trained nurses surveyed offer acupressure to patients. Busy oncology nurses noted significant barriers. Eighty-eight percent of nurses not previously educated are interested in learning. Reeducation of all infusion nurses is needed to overcome barriers, ensuring oncology nurses’ daily arsenals of tools includes acupressure for CINV.

Conclusion: Stressing the effectiveness, simplicity, and importance of acupressure for CINV with oncology nurses can help make it part of each chemotherapy patient visit. Having better understanding and increased comfort discussing and performing acupressure for CINV, oncology nurses can continue to empower patients and caregivers to take matters into their own hands to combat CINV.