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[Display omitted] Infectious complications are a significant cause of morbidity and mortality in patients with chemotherapy-induced neutropenia. Specific infection control practices targeting this patient population are widely endorsed, but little guidance exists on how to implement and monitor compliance with these practices. At our institution, we increased compliance with infection control measures by using a bundled neutropenic precaution (NP) audit and feedback tool. [ABSTRACT FROM AUTHOR]

Objective To review disease-related symptoms and side effects of treatment in patients with multiple myeloma (MM). Data Sources Peer-reviewed articles, research studies, and clinical guidelines. Conclusion New therapies provide patients with extended survival, but in many cases this benefit is counterbalanced by an increased incidence of side effects. Preservation of organ function, while managing side effects, is essential for the care of patients with MM. Implications for Nursing Practice Disease- and treatment-related adverse events are prevalent in patients with MM. Patient, family, and health care professional education is essential to monitor and manage these side effects. [ABSTRACT FROM AUTHOR]

Infections cause significant morbidity and mortality in patients with chemotherapy-induced neutropenia. Nursing practices exist that are proven to reduce infections in this population, however compliance with them is not routinely monitored. A quality improvement project was designed to monitor compliance with established Neutropenic Precautions (NP-bundle) for inpatient neutropenic cancer patients on an Oncology Unit from July 2015 through September 2018. A novel auditing tool was developed which included a patient interview, observation, and evaluation of the environment. Audits were scored by the infection preventionist IP) for compliance. The project was organized into four time-periods: Baseline period: All audits performed by IP to determine feasibility and areas of focus. Phase I was educating staff and fixing gaps discovered in the baseline period. Unit nurses trained to perform all audits. Phase II, unit leadership engagement and enforcement of mandatory number of audits to add accountability of auditing frequency. Phase III was the Sustainment period with reduction in unit leadership involvement. Audit scores significantly increased between baseline period (mean= 60%) and Phase I (mean= 82%, p<0.0001 by t-test). Engagement of leadership during Phase II was associated with significant increases in both the number of audits performed as well as mean audit score (97%, p<0.001). The largest improvements were observed in patient knowledge around proper bathing product use, increasing from 20% at baseline to 94%; and patient-reported Hand Hygiene compliance, increasing from 0% to 97%. During Phase III (sustainment), audit volume declined though mean audit scores remained high (98%). We developed a novel tool to assess compliance with key elements of neutropenic precautions. Education and peer auditing was associated with improved compliance. Engagement of unit leadership and increasing audit volume correlated with further improvement with compliance, which was sustainable with less direct leadership involvement. [ABSTRACT FROM AUTHOR]