| Description |
Background: Hypernatremia is a frequently encountered electrolyte abnormality in oncology patients due to cancer-related factors and treatment associated side effects. Despite its prevalence, management strategies remain inconsistent and provider-specific, leading to delays in care. Medical management toolkits and standardized protocols have been shown to improve patient outcomes and streamline clinical decision-making, yet no standardized hypernatremia protocol has been used on the oncology unit. Implementing a structured toolkit aims to improve provider confidence, streamline decision-making, and enhance patient outcomes. Local Problem: The current lack of standardized management of oncology inpatients with hypernatremia has led to inconsistent provider management, delays in treatment, and the need for patient transfers to higher levels of care. Additionally, provider confidence in managing hypernatremia varied, highlighting the need for a structured, evidence-based toolkit. Methods: A hypernatremia management toolkit was developed and implemented on an oncology inpatient unit to standardize the treatment of hypernatremia. Pre-, mid-, and post-implementation surveys were conducted among Advanced Practice Clinicians (APCs), and pre- and post discussions were completed with unit registered nurses to assess the toolkit's useability, feasibility, and impact on patient outcomes. Interventions: After a needs assessment review, key stakeholders identified the need for a standardized approach to hypernatremia treatment. The toolkit included clinical guidelines, a standardized treatment protocol, and educational resources to improve the recognition and management of hypernatremia. It was made easily accessible via email and incorporated into daily workflow practices. Results: Following implementation, providers reported increased confidence in hypernatremia management and could recognize the benefits of a standardized approach to treatment. Clinical protocol usage increased, and registered nurse (RN) respondents noted improved patient outcomes due to the timely recognition and treatment. Most providers found the protocol beneficial, though some challenges with workflow integration, accessibility, and additional training needs were identified. Conclusion: The introduction of a standardized hypernatremia management toolkit successfully addressed inconsistencies in care, increased provider confidence, and contributed to improved patient outcomes. The intervention was implemented without significant cost tradeoffs and demonstrated potential for sustainability and expansion to other clinical settings. Further research is needed to refine the toolkit, address remaining barriers, and evaluate long term impacts on patient care. |
