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Multidisciplinary Sarcopenia Care During Chemotherapy: A Quality Improvement Project
Hui-Ping Lin1, Su-Ying Yu, Li-Ting Ku
1Author Affiliations: Assistant Professor, School of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan (Dr. Lin); Head Nurse, Department of Nursing, Cancer Center, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan (Dr. Lin); Nurse Managment of Nurse Practitioner Services, Department of Nursing, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan (Dr. Yu); Case Manager, Department of Nursing, Cancer Center, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan (Ms. Ku); Nurse Practitioner, Department of Nursing, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan (Ms. Tsai); Professor, School of Nursing and Center for Health and Geriatric Care Research and Development, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan (Dr. Chen); Research Fellow, Department of Radiation Oncology, Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (Dr. Chen); and Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan (Dr. Chen).
Background:
Sarcopenia in older adults receiving chemotherapy contributes to functional decline, fatigue, and poor clinical outcomes.
Local Problem:
Baseline audits at a regional hospital in Taiwan identified fragmented sarcopenia care, with program enrollment and 12-week program completion rates of 16.0% and 33.0%, respectively.
Methods:
This quality improvement project used iterative Plan-Do-Study-Act cycles.
Interventions:
The intervention included a nurse practitioner-coordinated multidisciplinary sarcopenia care pathway, sarcopenia risk screening, individualized nutrition and exercise support, and structured digital follow-up.
Results:
Program enrollment and 12-week program completion rates increased to 80.0% and 72.0%, respectively. Run-chart analysis showed improvement in the chemotherapy-related sarcopenia outcome, with the observed incidence decreasing from 50.0% during early implementation to 37.0% during the maintenance phase. Fatigue and quality of life also improved.
Conclusion:
A nurse practitioner-coordinated multidisciplinary sarcopenia care pathway can be successfully integrated into routine oncology care and may improve nursing care quality.
