5 South’s Systematic Review on Lymphedema Precautions
5-South Evidence Based Practice Team <ul><li>Gabriela Barolette, RN (Author) </li></ul><ul><li>Laurie Cruz, RN </li></ul><...
H. Lee Moffitt Cancer Center & Research Institute
HOW OUR TOPIC WAS SELECTED <ul><li>5-South is a medical surgical floor in which many patients have had some form of breast...
Lymphedema <ul><li>What is it? </li></ul>
Lymphedema <ul><li>2 types: </li></ul><ul><li>Primary </li></ul><ul><li>Secondary </li></ul><ul><li>Lawenda, B.D., Mondry,...
Lymphedema Precautions <ul><li>We wanted to know the following: </li></ul><ul><li>When lymphedema precautions are necessar...
IMPORTANCE TO OUR UNIT <ul><li>Hospital policy regarding lymphedema precautions </li></ul><ul><li>Affect on nursing care <...
CHALLENGES WE ENCOUNTERED <ul><li>Lack of randomized clinical trials </li></ul><ul><li>Coordination of committee members’ ...
Methods and Resources Used <ul><li>Literature review </li></ul><ul><li>Databases </li></ul><ul><li>Breast surgeon survey <...
FINDINGS <ul><li>Factors reported to considerably increase   the risk of lymphedema </li></ul><ul><li>A study found that w...
FINDINGS <ul><li>Little evidence-based literature   on  precautions to reduce the risk of lymphedema </li></ul><ul><li>Maj...
FINDINGS <ul><li>We looked at a study that was designed to: </li></ul><ul><li>establish the prevalence   of patient-percei...
FINDINGS <ul><li>The study showed:  </li></ul><ul><li>Ways in which lymphedema is perceived </li></ul><ul><li>Most commonl...
FINDINGS <ul><li>Two of our breast surgeons suggested that  lymphedema precautions were to be implemented based on how man...
FUTURE RESEARCH NEEDS  <ul><li>How can this be proven? </li></ul><ul><li>Can this be proven? </li></ul>
References  <ul><li>American Cancer Society (n.d.). Lymphedema: What Every Woman With Breast Cancer Should Know. Retrieved...
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My floor\'s EBP committee\'s research on Lymphedema precautions 2010

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  1. 1. 5 South’s Systematic Review on Lymphedema Precautions
  2. 2. 5-South Evidence Based Practice Team <ul><li>Gabriela Barolette, RN (Author) </li></ul><ul><li>Laurie Cruz, RN </li></ul><ul><li>Marilyn McKelvey,RN </li></ul><ul><li>Wendy Pellegrino,RN </li></ul><ul><li>Carole Reed, RN </li></ul><ul><li>Patricia Rogers, RN </li></ul><ul><li>Jonessa Stanton, RN </li></ul>
  3. 3. H. Lee Moffitt Cancer Center & Research Institute
  4. 4. HOW OUR TOPIC WAS SELECTED <ul><li>5-South is a medical surgical floor in which many patients have had some form of breast cancer surgery thus increasing their risk for lymphedema </li></ul>
  5. 5. Lymphedema <ul><li>What is it? </li></ul>
  6. 6. Lymphedema <ul><li>2 types: </li></ul><ul><li>Primary </li></ul><ul><li>Secondary </li></ul><ul><li>Lawenda, B.D., Mondry, T.E., & Johnstone, P.A. , 2009 </li></ul>
  7. 7. Lymphedema Precautions <ul><li>We wanted to know the following: </li></ul><ul><li>When lymphedema precautions are necessary </li></ul><ul><li>Whether or not precautions are effective </li></ul><ul><li>Populations at risk for lymphedema </li></ul>
  8. 8. IMPORTANCE TO OUR UNIT <ul><li>Hospital policy regarding lymphedema precautions </li></ul><ul><li>Affect on nursing care </li></ul><ul><li>Affect on the patient </li></ul>
  9. 9. CHALLENGES WE ENCOUNTERED <ul><li>Lack of randomized clinical trials </li></ul><ul><li>Coordination of committee members’ schedules to meet and discuss research </li></ul>
  10. 10. Methods and Resources Used <ul><li>Literature review </li></ul><ul><li>Databases </li></ul><ul><li>Breast surgeon survey </li></ul><ul><li>Use of Moffitt library services </li></ul><ul><li>ONS PEP card </li></ul>
  11. 11. FINDINGS <ul><li>Factors reported to considerably increase the risk of lymphedema </li></ul><ul><li>A study found that women aged <60 years had a greater probability of lymphedema (41.2% versus 30.6%) when compared to women aged >60 years </li></ul><ul><li>(Lawenda et al., 2009) </li></ul>
  12. 12. FINDINGS <ul><li>Little evidence-based literature on precautions to reduce the risk of lymphedema </li></ul><ul><li>Majority of recommendations on lymphedema precautions are based on knowledge of the pathophysiology and years of clinical familiarity by experts in the field </li></ul><ul><li>(Lawenda et al., 2009) </li></ul>
  13. 13. FINDINGS <ul><li>We looked at a study that was designed to: </li></ul><ul><li>establish the prevalence of patient-perceived upper-extremity lymphedema </li></ul><ul><li>investigate medical and surgical factors linked to the development of patient-perceived lymphedema </li></ul><ul><li>investigate avoidant behaviors employed by women </li></ul><ul><li>compare objective upper extremity measurements with patient perceptions </li></ul><ul><li>McLaughlin, S.A., Wright, M.J., Morris, K.T., Sampson, M.R., & Brockway, J.P. , 2008 </li></ul>
  14. 14. FINDINGS <ul><li>The study showed: </li></ul><ul><li>Ways in which lymphedema is perceived </li></ul><ul><li>Most commonly avoided behaviors </li></ul><ul><li>Comparison between sentinel lymph node biopsy and axillary node dissection </li></ul><ul><li>McLaughlin, S.A., Wright, M.J., Morris, K.T., Sampson, M.R., & Brockway, J.P. , 2008 </li></ul>
  15. 15. FINDINGS <ul><li>Two of our breast surgeons suggested that lymphedema precautions were to be implemented based on how many lymph nodes were removed. </li></ul><ul><li>We did not find any literature to support or negate the above statement. </li></ul>
  16. 16. FUTURE RESEARCH NEEDS <ul><li>How can this be proven? </li></ul><ul><li>Can this be proven? </li></ul>
  17. 17. References <ul><li>American Cancer Society (n.d.). Lymphedema: What Every Woman With Breast Cancer Should Know. Retrieved August 15, 2009, from http://www.cancer.org/docroot/MIT/content/MIT_7_2x_Lymphedema_and_Breast_Cancer.asp </li></ul><ul><li>Lawenda, B.D., Mondry, T.E., & Johnstone, P.A. (2009). Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment . CA: A Cancer Journal for Clinicians , 59(1), 8-24. </li></ul><ul><li>McLaughlin, S.A., Wright, M.J., Morris, K.T., Sampson, M.R., & Brockway, J.P. (2008). Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: patient perceptions and precautionary behaviors. Journal of Clinical Oncology , 26(32), 5220-5226. </li></ul>
  18. 18. Questions
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