Date of Award

Fall 2025

Project Type

Clinical Doctorate

Department

Nursing

Program or Major

DNP

First Advisor

Catherine Colleran

Abstract

BACKGROUND: The American Cancer Society estimates 2,041.90 new cases of cancer in the U.S. (1 in 18 Americans) with a global projection of thirty-five million new cases annually by 2050. With this alarming increase, early recognition of oncological emergencies in the Emergency Departments is essential. Life-threatening conditions require rapid assessment, accurate diagnosis, and immediate interventions. Qualified emergency nurses must understand the effects that cancer and treatment have on the immune, metabolic, and hematologic systems. This quality improvement (QI) project focuses on assessing emergency nurses’ oncological knowledge of acute emergencies and providing a resource for rapid identification.

PROBLEM STATEMENT: Oncological Emergencies need to be on the same trajectory as any other acute emergency. Are emergency nurses capable of recognizing and managing these emergencies? Are educational resources available to provide immediate information?

METHODS: Emergency Nurses were encouraged to voluntarily participate in this QI project. The Technology Acceptance Model (TAM) theoretical model was utilized in the ED Digital Practice Support site at Brigham and Women’s Emergency Department. Oncological Emergency Huddle Cards developed by the Oncological Nursing Society were maintained in the ED Digital Support Site available with every patient chart addressing the 7 most acute oncological emergencies. A pre and post ten question Likert scale survey was distributed via UNH Qualtrics to the voluntary emergency nurses. A project implementation and post-survey review was completed.

RESULTS: A total of 191 Emergency Department RNs were invited to participate in this QI project. Survey data was analyzed by descriptive analysis over 8 weeks from September 8 4 through November 3, 2025. 7.85% of the nursing staff participated initially in this QI project with 20% of the initial participants completing the final evaluation. During this time 9,056 patients’ presented to the Emergency department. 588 patients were admitted to oncology service. 3 patients were identified as acute oncological emergencies that fit the qualifications to be included in this QI project and were cared for by 3 of the participating RNs.

CONCLUSION: Recognition of Oncological Emergencies requires specialized focused knowledge and treatment. 47% of the nursing staff agreed that they felt a knowledge deficit in providing care to acute oncology patients. Only 7.85% participated, 39.1% felt that due to shift responsibilities and workload volume that they were unable to participate even though ONS Huddle Cards of Oncological Emergencies maintained in the Digital Support Practice site were readily available to promote self-education, enhance critical thinking and assist in navigating complex clinical cases rapidly. This project had a low participation rate. Those that participated did express satisfaction with the quick accessibility to the ONS Huddle Cards that assisted them in directing their care with a patient with an acute oncological emergency. The recommendation for the nursing staff was for a more formalized Oncological Educational program due to the complexity of these oncological emergencies. This would provide a foundation for knowledge that would be supported by the ED Digital support site ONS Huddle Cards.

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