Supporting Evidence-Based Practice at the Phyllis F. Cantor Center

Science and Practice Aligned Within Nursing (SPAWN)©

SPAWNing is an infrastructure and process for:

  • Bi-directional contributions between clinical, direct-care nurses, and nurse scientists
  • Generation of research questions originating from and embedded in practice
  • Translating results of research studies into everyday practice

SPAWNing groups meet on a regular basis in each clinical area of Dana-Farber and its satellites. The Clinical Inquiry Specialists support the groups, providing guidance and process facilitation.

Featured Evidence-Based Practice Project

Project: Central Venous Access Device Flushing
Collaborating Units: Cantor Center, Adult Ambulatory Services, Center for Patient Safety

Central Venous Access Devices (CVADs) allow patients with cancer to have reliable venous access for IV therapy that is needed throughout cancer treatments. Maintenance of CVADs is a critical nurse responsibility that is important for safety and to ensure high quality care for patients. Historically, Heparinized Saline (HS) has been the standard solution used for locking central venous access devices (e.g., CVADs) between uses. Recent research indicates that Normal Saline (NS) is a safer, equally effective alternative to HS, and that combined with evidence-based flushing techniques, optimum clinical outcomes are achieved. However, there is resistance among both nurses and patients to changing these long-established flushing practices. The specific aims of this evidence-based practice project were to evaluate the effect of a peer nurse mentoring intervention on 1.) nurses’ perspectives about using NS verses HS for locking CVADs, 2.) patients’ perspectives about the use of NS versus HS for locking CVADs; 3.) nurse perspectives about implementing an evidence-based practice change in flushing and locking CVADs; and 4.) to evaluate differences in patency when flushing CVADs with NS versus HS.


Symptom Management Excellence (SME)

Symptom Management Excellence (SME) was launched in 2010 as a special SPAWNing initiative. Based on data from Dana-Farber nurses and patients, Dr. Berry and her staff have identified three symptoms that are not only prevalent in Dana-Farber patients, but have evidence-based interventions with which to treat the symptoms: fatigue, anorexia, and anxiety. A critical appraisal of the literature was conducted, and two projects related to fatigue and anorexia were completed and efforts are now being deployed to implement the initiatives on a larger scale. The next efforts will focus on addressing anxiety and bringing evidence based anxiety interventions to practice.

SME References

Underhill, M.L., Boucher, J., Roper, K. and Berry, D.L., 2012. Symptom management excellence initiative: promoting evidence-based oncology nursing practice. Clinical journal of oncology nursing, 16(3).

Berry, D.L., Blonquist, T., Nayak, M.M., Roper, K., Hilton, N., Lombard, H., Hester, A., Chiavacci, A., Meyers, S. and Mcmanus, K., 2018. Cancer Anorexia and Cachexia: Screening in an Ambulatory Infusion Service and Nutrition Consultation. Clinical journal of oncology nursing, 22(1), pp.63-68.