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Utilité d’une évaluation infirmière systématique du risque de neutropénie fébrile induite par la chimiothérapie
Abstract
Les lignes directrices fondées sur les preuves recommandent que les patients à risque élevé (≥ 20 %) de neutropénie fébrile (NF) reçoivent des facteurs de croissance hématopoïétiques à titre prophylactique (Aapro et al., 2006; Koroukis et al., 2008; National Comprehensive Cancer Network [NCCN], 2008; Smith et al., 2006). Nous avons étudié l’utilité de faire effectuer par les infirmières une évaluation systématique du risque de NF chez les nouveaux patients avant le commencement de la chimiothérapie. Quinze infirmières ont utilisé un outil normalisé afin d’évaluer le risque de NF chez 150 patients. Chez 94 % des patients ainsi examinés, les infirmières ont décelé des facteurs de risque exigeant des interventions en vue de réduire l’incidence de la NF. Lors de la phase finale d’évaluation de l’outil, 67 % des infirmières ont déclaré que l’emploi d’un outil normalisé les avait aidées à identifier les patients à risque de NF, et 73 % d’entre elles projetaient d’évaluer systématiquement le risque de NF. Les infirmières trouveront que l’évaluation du risque de NF au moyen d’une liste de contrôle normalisée avant le commencement de la chimiothérapie est une procédure à la fois réalisable et fort utile.
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