“I persuaded a physician to stop using aloe vera to treat radiodermatitis because of the Guideline recommendation (https://www.ons.org/articles/ons-guidelinestm-cancer-treatment-related-radiodermatitis) to only use aloe vera in a clinical trial setting,” one participant explained. She stated that the physician agreed to the change because she was able to show him the evidence.  

Applying Evidence to Patient-Centered Care

To better understand how nurses are using the Guidelines and define future editions, ONS conducted a video focus group with 14 oncology nurses using the Guidelines in direct patient care: five clinicians, three nurse educators, and six advanced practice RNs. During the conversations, the nurses reported using them in five different aspects.

Symptom management: Nurses are using the guidelines to both support best practices and to identify symptom treatment alternatives if other methods aren’t working. “The Constipation Guideline (https://www.ons.org/articles/ons-guidelinestm-opioid-induced-and-non-opioid-related-cancer-constipation) is my bible,” one nurse said. That nurse also extrapolated the information to apply it to pediatric patient care.

Patient education: “Patients respond well to hearing that a treatment is evidence based,” one participant said. Already the most trusted profession for 20 years in a row (https://news.gallup.com/poll/388649/military-brass-judges-among-professions-new-image-lows.aspx), the nurses reported becoming even more trustworthy to patients when they said that their recommendations came from an evidence-based resource. The participants said that since using the Guidelines, patient satisfaction and outcomes have both improved.

Staff education: When using the Guidelines for teaching and training, the nurse educators praised ONS’s credibility and trusted that the information was current, accurate, and reliable. And because the Guidelines provide such comprehensive content, the nurses said they’ve improved their educational planning efficiency.

Care team discussions: In addition to using the Guidelines to support advocating for the best and most appropriate patient care, the nurses reported sharing them with team members from other disciplines, most notably physical therapists and radiation technicians. Other participants echoed the nurse’s experience from the beginning of this article, demonstrating the trust physicians have in ONS’s rigorous evidence evaluation process.

Policymaking and committee work: Several nurses in the focus groups participated on committees or other leadership groups in their organizations, and they reported using the guidelines to support their committee work or develop institutional policies and procedures.

Opportunities for Future Guideline Editions

As ONS continues to develop new Guideline topics and update the current ones, the focus group helped identify enhancements for future releases. Some suggestions included:

• Producing a one-page quick-reference version to use directly at the point of care
• Developing a mobile app
• Offering the Guidelines at the institutional licensing level so other care team members can access them

“The feedback we received from the nurses in the focus groups will help us improve existing and offer insight for new products,” Michele Galioto, DNP, RN, CNS, executive director for the ONS Center for Innovation, said. “The process was a different way for ONS to gather real-world usage reports from our oncology nurse customers and may represent a new approach for ONS to collect product feedback in the future.”

Learn more (https://www.ons.org/ons-guidelines) about the ONS Guidelines and access a list (https://www.ons.org/ons-guidelines) of the current topics.