Evaluation of a nausea assessment tool in the pediatric oncology population

Nausea is a symptom that is often experienced but misunderstood. Its impact is amplified in pediatric oncology patients. Nausea assessments in pediatric oncology are few and not yet widely used. The Baxter Retching Faces (BARF) scale holds promise and is used in some pediatric oncology units. The purpose of this evidence-based practice project was to evaluate the impact of the BARF scale on nursing assessments in inpatient pediatric hematology/oncology and stem cell transplant settings.

Project work took place on one hematology/oncology unit and one stem cell transplant unit. Thirty nurses completed the acceptability of intervention measure (AIM), intervention appropriateness measure (IAM), and feasibility of intervention measure (FIM) to provide initial feedback on the BARF scale. Nurses used the BARF scale over an 8-week period. Patient demographics and BARF scores were collected during nausea assessments. Twenty nurses completed AIM/IAM/FIM scores postintervention. There were no significant changes in scores, though nurses stated that the tool was easy to use and provided valuable symptom feedback.

Symptom management will continue to be a challenge in the pediatric setting given developmental and disease-specific considerations inherent to the specialty. While this small-scale project did not achieve statistical significance, the evidence and feedback from nursing staff present a compelling case that efforts to investigate and integrate improved methods of assessing nausea and other problematic symptoms are needed to enhance nursing practice and impact patient-centered outcomes.