Reducing Oral Mucositis: A Quality Improvement Project in a Pediatric Hematology-Oncology Setting
Research Poster Health & Life Sciences 2025 Graduate ExhibitionPresentation by Hailey Cleveland
Exhibition Number 85
Abstract
Problem: Oral mucositis is a prevalent problem, developing in 52%-81% of pediatric patients receiving chemotherapy worldwide. A pediatric hematology-oncology unit at a tertiary children’s hospital noted development of mucositis in an estimated 50% of 25 children who received chemotherapy within a three-year timeframe. Within that timeframe, there were no unit-specific guidelines or interventions in place for prevention of mucositis. Purpose: Implementation of a mucositis prevention guideline may improve quality of patient care by increasing staff awareness and adherence to nursing care practices. An evidence-based guideline for mucositis prevention was implemented with the goal of reducing adverse effects of treatment. Reducing oral mucositis has been shown to yield better patient outcomes by reducing risk of infection and other serious complications. Project Implementation: An evidence-based mucositis prevention guideline with a focus on cryotherapy intervention was introduced on an 18-bed hematology-oncology unit in children's hospital. Nursing compliance with guideline and nursing perception of the intervention was assessed through nursing documentation and surveys. Evaluation: Nursing perception of acceptability, appropriateness, and feasibility of a mucositis prevention guideline and mucositis documentation were evaluated with Chi-square analysis. Participant perception of feasibility (p=0.05), nursing documentation of mucositis scores (p=0.0002) and implementation of cryotherapy (p=0.014) improved post-implementation. Conclusions: Implementation of a mucositis prevention guideline has been shown to positively impact nursing quality of care and documentation while decreasing patient harm. There was a significant increase in delivery of oral cryotherapy post-implementation of the educational guideline. All candidates who received cryotherapy did not develop mucositis.
Importance
Oral mucositis is a common, highly preventable adverse effect of cancer treatment modalities. As cancer affects almost 2 billion people per year in the United States alone, prevention of these adverse effects should take priority. Mucositis prevention is implicated in nursing because this adverse effect may be preventable with simple nursing education and preventative practices. Oral cryotherapy is one of the few successful, cost-effective, nursing-led preventative options for patients undergoing cancer treatment. Delivery of safe, quality care includes not only standard treatment of the underlying condition, but prevention of harm and further complications with provision of excellent nursing care and interventions such as this.