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The Nurse’s Role in Managing Chemotherapy-Induced Nausea and Vomiting: An International Survey

Krishnasamy, Meinir PhD, RN; Kwok-Wei So, Winnie PhD, RN; Yates, Patsy PhD, RN; de Calvo, Luz Esperanza Ayala MEd, RN; Annab, Rachid BSc (Hons); Wisniewski, Tami RN; Aranda, Sanchia PhD, RN

doi: 10.1097/NCC.0b013e3182a3534a
Articles: Online Only

Background: Nurses play a substantial role in the prevention and management of chemotherapy-induced nausea and vomiting (CINV).

Objectives: This study set out to describe nurses’ roles in the prevention and management of CINV and to identify any gaps that exist across countries.

Methods: A self-reported survey was completed by 458 registered nurses who administered chemotherapy to cancer patients in Australia, China, Hong Kong, and 9 Latin American countries.

Results: More than one-third of participants regarded their own knowledge of CINV as fair to poor. Most participants (>65%) agreed that chemotherapy-induced nausea and chemotherapy-induced vomiting should be considered separately (79%), but only 35% were confident in their ability to manage chemotherapy-induced nausea (53%) or chemotherapy-induced vomiting (59%). Only one-fifth reported frequent use of a standardized CINV assessment tool and only a quarter used international clinical guidelines to manage CINV.

Conclusions: Participants perceived their own knowledge of CINV management to be insufficient. They recognized the need to develop and use a standardized CINV assessment tool and the importance of adopting international guidelines to inform the management of CINV.

Implications for Practice: Findings indicate that international guidelines should be made available to nurses in clinically relevant and easily accessible formats, that a review of chemotherapy assessment tools should be undertaken to identify reliable and valid measures amenable to use in a clinical settings, and that a CINV risk screening tool should be developed as a prompt for nurses to enable timely identification of and intervention for patients at high risk of CINV.

Author Affiliations: Peter MacCallum Cancer Centre and Faculty of Medicine, Dentistry, and Health Sciences, The University of Melbourne, Victoria, Australia (Drs Krishnasamy and Aranda and Mr Annab); Nethersole School of Nursing, Chinese University of Hong Kong, China (Dr Kwok-wei So); School of Nursing and Midwifery, Queensland University of Technology, Queensland, Australia (Dr Yates); School of Nursing, Pontificia Universidad Javeriana, Bogota, Colombia (Ms de Calvo); Merck & Co Inc, Whitehouse Station, New Jersey (Ms Wisniewski); Cancer Institute New South Wales, Sydney, Australia (Professor Aranda).

This study was supported through a collaboration between the International Society of Nurses in Cancer Care and Merck, Inc, through an unrestricted educational grant.

The authors have no conflicts of interest to disclose.

Correspondence: Meinir Krishnasamy, PhD, RN, Peter MacCallum Cancer Centre, St Andrew’s place, East Melbourne, Victoria, Australia 8006 (

Accepted for publication July 2, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins