Implementation plan
The problem of cancer pain amongst oncology care patients need to be given the required attention as a way of seeing to it that such individuals are able to emerge with desirable outcomes. It is important for pain alleviation programs to be put into place to make sure that such individuals are able to manage their conditions and assists them incorporate into the society. As such, it is essential that all due processes are followed to guarantee that pain alleviation amongst cancer patients is achieved. Having in place a proper implementation program will be an important step in achieving this objective while at the same time ensuring that all the necessary resources that need to be incorporated into the process are used in the most economic way possible. There is the need for following a particular process which will oversee the implementation of the program. As such, the first step in implementing this program will be seeking the necessary approval from the hospital’s management where this program will be laid out.
Section 1: securing support and approval for proposal
It is important to acquire the required approvals from the relevant authorities in regards to the program implementation process. Rolling out a particular change in the workplace requires that permission is granted so that in the case of any mishaps occurring along the way, the management care is in a better position to take the most appropriate remedial measures which will address them. To this effect, therefore, a letter detailing the proposed solution will be written to the relevant authorities at the hospital to bring them up to speed regarding the developments. Additionally, a project proposal detailing all the steps that will be followed and the financial implications will be presented to the key stakeholders in this meeting. It is during the meeting that the need for utilizing complementary and alternative medicine (CAM) will be aired and most specifically the use of massage therapy in alleviating pain amongst oncology patients.
Section 2: description of the problem
Patients in the post-cancer treatment units are in constant pain due to the side effects that usually come about as a result of the cancer treatment rigorous process. In the event that they are not provided with the required care, their outcomes in regards to pain management are likely to be compromised thus leading to reduced satisfaction levels and more pain being inflicted on them. Such pains are usually influenced by the emotional, environmental and the physical conditions that an individual currently faces (Smith & Saiki, 2015). These pains are usually brought about by issues like tumor growths, extensions of cancer to bones of the body, pressure on organ, nerves, and bones in addition to chemotherapy side effects. The fact that individuals who usually perceive such pains usually go through a lot emotional, environmental and physical challenges like hopelessness, embarrassment, and helplessness mean that they need to be provided with the best pain alleviation programs. To this effect, therefore, there is the need for having in place measures which will play a crucial role in controlling the pain instances.
There are two major ways through which this problem can be addressed including the use of traditional analgesics and complementary medicine techniques. These two measures have been used in alleviating the pains that such patients usually go through even though there are several side effects that have linked with the usage of analgesics for instance vomiting and nausea (Smith & Saiki, 2015). To this effect, therefore, the use of massage therapy is useful in managing this pain as it does not have any side effects on the patients and has also been proven to address the problem in a holistic manner. Massages have also been shown to improve the appetite of the patient in addition to creating a mood of relaxation.
Section 3; proposed solution
The corrective mechanisms which can be out in place in regards to the alleviation of the pains brought about by cancer treatment have been established to be either through the use of analgesics or massage therapy. However, due to the undesirable side effects that have been associated with the use of traditional analgesics, it is imperative that care providers make use of massage technique in addressing this problem (Starkey, 2013). There are several massage techniques which can be used to relieve patients from the pain associated with the cancer treatment process. The different techniques used include the Swedish massage therapy, aromatherapy, deep tissue massage, and reflexology and trigger point massage.
This technique involves massage therapist making use of smooth strokes, which are kneaded in a circular motion. These strokes are done around the superficial layers of muscles by applying lotion used for massages (Starkey, 2013). This massage therapy is effective in addressing cancer pain as it creates a sense of relaxation to the patient.
Aromatherapy massage
This type of massage involves the addition of particular scented plants in the massage process to address specific issues brought about by the different forms of cancer pain. The plants used in the process are referred to as essential oils and are useful in terms of reducing stress, energizing, relaxation and most importantly pain reduction (Starkey, 2013).
Deep tissue massage
This massage technique is aimed at alleviating deep-seated pains mostly in the deeper muscle layers and the connective tissues. This is the most effective Massage technique for pain as it employs the use of slower strokes across the muscle grains (Starkey, 2013). However, individuals who have gone through this form of massage usually develop feelings of soreness one or two days after the process.
Reflexology massage
This massage technique involves the application of pressure on particular parts of the feet which are deemed to be connected with specific systems and organs of the body. Such type of massage is essential especially for individuals who may have gone through foot cancer treatment. Also, this form of massage is very relaxing.
Trigger point massage therapy
This form of massage is aimed at relieving cancer pain emanating from a single point in the body. A trigger refers to an area in the muscular area which causes pain that spreads to other parts of the body. This technique aims at addressing the source of the pain by the application of isolated pressure which comes in the form of cycles (Starkey, 2013). The objective of this technique is to prevent the pain from spreading to the other parts of the body.
Section 4: rationale for selecting proposed solution
The control of cancer pain requires that the technique being used takes into consideration the issue of holistic care resulting to the patient. Therefore, comparing the use of traditional analgesics and massage therapy in controlling cancer pain in oncology care patients, the medications have been linked with several side effects which compromise the patient quality of life and satisfaction levels. As such, the use of massage therapy is essential as it addresses the problems from the root cause resulting in better outcomes in terms of body relaxation, higher appetite levels to the patient in addition to the general feeling bodily relief. This form of pain relief is effective in as it results in better patient outcomes. Massages have also been proven to result in feelings of comfort, caring, and connection.
Section 5: literature review
According to Sagar, Dryden and Wong (2007), cancer pain has been established to be a major issue compromising the quality of life of oncology care patients. To this effect, therefore, it is imperative that the most appropriate measures be taken to alleviate the problem of which massage therapy is the most preferred. This technique has been proven to be effective in controlling cancer pain since it softens body tissues thus resulting in improved coping levels. Another study done by Warpenburg (2014) identifies chemotherapy used for treating breast cancer as being the primary cause of pain to most cancer patients. These therapy sessions are usually aimed at improving the life quality of these patients. As a measure of ensuring that the condition is fully addressed, it is essential that deep friction massage is used in addressing the pain as it reduces inflammation tendencies by destroying the fibrotic tissues. Miladinia et al (2015) posit that deep back massages are useful techniques in addressing the issues of nausea and vomiting which have been proven to be side effects of cancer therapy. In most instances, nausea and vomiting have always been associated with post-treatment pain and as such, massages are useful in addressing it. Finally, Bedard et al (2013) in a quantitative study identify some of the reasons why patients battling breakthrough cancer pain do not prefer analgesics. The reasons include the costs involved, the fear of addiction and the severity of the condition. As such, they propose the application of alternative forms of pain control such as massages in addressing the condition. Such a move is aimed at alleviating the pain in this group of patients.
Section 6: description of implementation logistics
Program implementation requires that different stakeholders be involved in the process as a way of ensuring that all facets of the projects have been addressed. Therefore, multiple professionals will be incorporated in the process to ensure that the project becomes a success. Thus, the specialists who will be involved in addressing this problem will include an oncology clinical nurse specialist (CNS), a dietitian, 3 massage therapists, an accountant, and a nurse informaticist. This program will be rolled out in line with the mission, vision, and goals that guide the operations of the organization. Such a move will be crucial in making sure that the traditions and culture of the healthcare setting have been linked with the program. Additionally, all the professionals involved in rolling out the program will be trained while on their daily caregiving activities as a way of ensuring that they gain hands-on experience in regards to the management of cancer pain. It will be the responsibility of the oncology CNS to ensure that the flow of work at the organization is not interrupted after initiating this change project.
In regards to the different roles which the stakeholders will be required to perform, the dietitian will be responsible for ensuring that the foods these patients consume do not result in cases of nausea and vomiting after the therapy sessions. The accountant will be tasked with taking care of the financial implications of the project. The 3 massage therapists will be useful in regards to performing the required pain relieving practices on these patients. The nurse informaticist will be involved in maintaining the patients’ progress in online medical records for easy retrieval and cross-referencing. The oncology CNS will also double up as the educator to the stakeholders in regards to the management of the pain in cancer patients owing to the 12 year-experience that he has concerning cancer pain management. Brochures and pamphlets containing information on the management of the condition will be the main education materials utilized in the education process.
Section 7: resources required for implementation
Program resource requirements
Main stakeholders
1 Oncology CNS, 3 massage therapists, 1 dietitian, an accountant, and a nurse informaticist.
Program assessment checklist
The functionality of this checklist will be aimed at ascertaining that the program has achieved its objectives. The rates of pain incidences in the post treatment group of cancer patients will be the metrics under which the program’s success will be evaluated. The Oncology CNS will be tasked with ensuring that the checklists are distributed to the required stakeholders then collected for accountability and recording purposes. Properly filled checklists will be used to show the seriousness of the program. Reviews of the checklists will be conducted by the main stakeholders involved.
Technological requirements
The chief technological requirement for this project will be utilizing electronic health records in storing the information extracted from the assessment checklists.
Finances
Program budget
The process of program initiation, evaluation and overseeing will be the responsibilities of the oncology CNS who also doubles up as the nurse manager at the healthcare setting.
References
Bedard, G., Hawley, P., Zhang, L., Slaven, M., Gagnon, P., Bisland, S., & Chow, E. (2013). A survey of Canadian cancer patients’ perspectives on the characteristics and treatment of breakthrough pain. Supportive Care in Cancer,21(9), 2557-2563.
Miladinia, M., Baraz, S., Mousavi Nouri, E., & Gholamzadeh Baeis, M. (2015). Effects of Slow-stroke Back Massage on Chemotherapy-induced Nausea and Vomiting in the Pediatrics with Acute Leukemia: a Challenge of Controlling Symptoms. International Journal of Pediatrics, 3(6.2), 1145-1152.
Sagar, S., Dryden, T., & Wong, R. K. (2007). Massage therapy for cancer patients: a reciprocal relationship between body and mind. Current oncology,14(2).
Smith, T. J., & Saiki, C. B. (2015, October). Cancer pain management. InMayo Clinic Proceedings (Vol. 90, No. 10, pp. 1428-1439). Elsevier.
Starkey, C. (2013). Therapeutic modalities. FA Davis.
Warpenburg, M. J. (2014). Deep Friction Massage in Treatment of Radiation-induced Fibrosis: Rehabilitative Care for Breast Cancer Survivors. Integrative Medicine: A Clinician's Journal, 13(5), 32.
