Graduation Semester and Year

Spring 2024



Document Type


Degree Name

Doctor of Nursing Practice



First Advisor

Nancy Nagel


This quality improvement (QI) project aims to enhance the care of adult female patients with invasive breast cancer who are prescribed oral oncolytic agents by improving the monitoring of lab results and follow-up visits.

Purpose: The project addressed the critical need for a standardized monitoring process for patients on oral oncolytic therapy, focusing on compliance with lab monitoring and follow-up care.

Methods: Utilizing the Plan- Do- Study- Act (PDSA), the project implemented an oral oncolytic care bundle. This bundle included resources for individualized patient plans, shared decision-making tools, and the use of smart phrase technology within the electronic health record (EHR) system to improve communication between patients and providers. The intervention aimed to ensure that lab monitoring and follow up appointments were aligned with the start of the oral oncolytic therapy cycles to align with monitoring parameters.

Findings: Preliminary data analysis revealed significant gaps in lab monitoring compliance, which this care bundle aimed to address. Post intervention analysis indicated improved scheduling of lab work and follow up visits to better align with the treatment cycles and enhanced patient provider communication. The compliance rate for lab monitoring and follow up visits improved significantly with a P value of 0.02, indicating A statistically significant improvement due to the intervention.

Significance: By leveraging the EHR technology, the QI project showed opportunities for improvement in monitoring patients taking oral oncolytic agents. Implementation of an oral oncolytic monitoring program resulted in better management of oral oncolytic therapy, reduced adverse events, and improved patient outcomes. Enhanced communication and proactive monitoring guidelines further supported the patient through their oral oncolytic journey. These interventions led to a more positive patient experience resulting in higher patient satisfaction scores.


oral chemotherapy, oral oncolytic, monitoring, lab monitoring, anti-neoplastics



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