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2023 Sigma/ANCC Grant Awardee

Annette Brant Isozaki, MSN, RN

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RESEARCH PROJECT: On the BRINK: PhotoBiomodulation (PBM) for Mucositis in Patients Undergoing Allogeneic Hematopoietic Stem Cell TRansplant (HSCT) – Implementing the Evidence & Discovering New Knowledge

BIO: Annette Isozaki is a registered nurse and charge nurse on the Bone Marrow Transplant, Chimeric Antigen Receptor T-Cell Therapy, and Investigational Therapy unit at the City of Hope National Medical Center in Duarte, California. She has several publications covering topics such as mucositis management, pain management, and spiritual care of patients with cancer. Annette recently graduated with her Master of Science in Nursing degree as a Family Nurse Practitioner. She hopes to continue her career at the City of Hope National Medical Center as a Nurse Practitioner, caring for the holistic needs of patients and families impacted by cancer.

ABSTRACT: Background of the Clinical Issue: Oral mucositis (OM) is a debilitating and potentially fatal condition in roughly 80% of patients undergoing hematopoietic stem cell transplantation (HCT). OM can lead to infection, pain, need for nutritional support, decreased quality-of-life, and prolonged hospitalization. Research shows palifermin and photobiomodulation (PBM) as Level I interventions effective in reducing OM severity in this population; lack of data exists on the efficacy of treating OM and its impact on pain, taste, and xerostomia. A national shortage of palifermin has OM nationwide.

Study Purposes: The purpose of this study is to implement PBM into practice and compare patient outcomes to historical controls with no PBM. Secondary objectives aim to reduce pain, xerostomia, and taste changes and examine the costs of using PBM.

Methods to Include the Intervention and Implementation: This project will implement PBM into the clinical setting using the Iowa Model. Individuals over age 18 undergoing HCT at City of Hope will be enrolled. Patients will be administered PBM starting on day -1 and will continue to receive daily PBM until Day +21 or discharge. If the patient develops OM, an additional dose of PBM will be administered to treat OM. Nurses will assess the oral cavity each shift and document findings in the electronic health record. Data will be analyzed using descriptive statistics and independent sample t-tests will be used to measure changes between the PBM group and those not treated with PBM.

Expected Evidence Contribution and Significance: This study has potential to serve as a model program nation-wide to implement PBM organizationally, while contributing to new knowledge about the treatment of OM and the impact of PBM on pain, taste, xerostomia, and costs compared to not using PBM. This study also allows implementation science and research capacity building among nurses, a primary goal of Sigma.

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