Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Embargo Period
10-18-2019
Degree Program
Doctor of Nursing Practice
Degree Track
Post Master's DNP Completion
Year Degree Awarded
2019
Month Degree Awarded
May
Keywords
De Novo Cancer Monitoring, Heart Transplantation, Telephone Follow-up, Malignancy, Chronic Immunosuppression
Advisor
Dr. Jeungok Choi, RN, PhD
DNP Project Chair
Dr. Jeungok Choi, RN, PhD
DNP Project Outside Member Name
Dr. Paolo C. Colombo
Abstract
“De Novo Cancer Monitoring for Adult Heart Transplant Patients to Improve Early
Detection and Intervention”
Abstract
Background. The surgical advancements in orthotopic heart transplantation along with improvements in immunosuppressive drugs increase the survival rate and quality of life of heart transplant recipients. However, the prolonged use of immunosuppressive medications increases the risk of infection and related cancer. Solid organ transplant recipients have approximately two to three-fold higher risk of developing de novo cancers. Thus, modulation of immunosuppression regimen and cancer screening appear as key factors in preventing and treating de novo cancer among solid organ transplant recipients.
Purpose: The purpose of this project was to examine the effectiveness of multiple follow-up phone calls after clinic visits as an intervention to enhance compliance with cancer surveillance in adult heart transplant recipients.
Methods: The convenience sample of consenting participants (n= 41) was randomly divided into intervention (n = 21) and control (n=20) groups. The intervention group received multiple follow-up phone calls at designated time intervals after a clinic visit to reinforce compliance with cancer screening. The control group continued to receive routine care.
Results: The intervention resulted in a significant statistical difference (χ2 (1) = 4.062, p=0.044<.05) between the control and the intervention groups for timely cancer screening. The intervention group had a 50% follow-up with a specialist compared to the 15% follow up-rate of the control group.
Conclusion: A nurse practitioner-led multiple follow-up phone calls was effective in increasing de novo cancer screening among adult heart transplant recipients.
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