News — New Brunswick, N.J., April 19, 2023 – An insulinoma is a rare tumor that forms in the pancreas and is usually benign. This type of tumor produces extra insulin, which can cause a person’s blood sugar to drop to dangerously low levels, causing symptoms such as confusion, sweating, weakness and a rapid heartbeat. Most patients with benign insulinomas can be cured with surgery, and nursing care is necessary in the preoperative, intraoperative, and postoperative stages of this condition. However, standardized nursing care for patients with this type of tumor is currently lacking. Kellie Zeichner BSN, RN, OCN; John Rodriguez BSN, RN, OCN; Yuk Wong MA, BSN, OCN and Donna Thomas BSN, RN, OCN, oncology nurses at Rutgers Cancer Institute of New Jersey, share more about this topic, which will be presented as a poster at the being held April 26 to April 30 in San Antonio, Texas.

What are the current challenges that oncology nurses are facing related to the care of patients with insulinoma?

Insulinoma is a rare condition that may never be seen in many outpatient oncology infusion areas.  Even in our National Cancer Institute (NCI)-designated Comprehensive Care Center, we may only care for a few patients annually in our infusion areas. Because of this, the biggest challenge that oncology nurses face stems from having limited knowledge about the disease and the significant role we play in diagnosing these patients. In addition, the crucial part of establishing an insulinoma diagnosis is getting the patient to a state of hypoglycemia. The patient may experience significant symptoms requiring continuous observation and immediate medical intervention. Due to unfamiliarity and a knowledge deficit, oncology nurses might not feel comfortable or confident about the diagnosing process. They might apply interventions early in the process that can affect the outcome. Also, providing patient education can be challenging for oncology nurses because of the limited resources and evidence-based information on insulinoma. 

Why are standardized monitoring procedures for insulinoma patients important?

After performing a baseline analysis of nursing knowledge of insulinoma, we discovered a knowledge gap. In an interdisciplinary collaboration with pharmacy staff and our physician colleagues, we developed evidence-based educational interventions to bridge the gap and thereby improve their proficiency in caring for patients with this disease. In a fast-paced outpatient Infusion area, nurses require readily available, easy-to-access resources to maintain confidence in providing high-quality, safe, and efficient care. Utilizing the best available evidence-based knowledge to develop a standardized nursing process will help to maintain patient safety while improving the quality of care and patient outcomes. Moreover, because of the rarity of insulinoma, it is important to have and maintain standardized nursing procedures to review with nursing staff and have them available for reference when needed to assist in diagnosing this complex disease.

What is the benefit of receiving this type of care at a National Cancer Institute-designated Comprehensive Cancer Center like Rutgers Cancer Institute?

As the state’s only NCI-designated Comprehensive Cancer Center together with RWJBarnabas Health, patients receive cutting-edge treatment characterized by the integration of scientific and clinical expertise and the most current research to establish excellence in cancer care. We also have a very dedicated nursing leadership and education department of oncology certified nurses and advanced practice nurses that consistently use evidence-based research to continually improve the standards of nursing care of patients with insulinoma and, just as important, diagnosis of this condition.

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At Rutgers Cancer Institute, together with , the state’s  and , nurses serve as critical members of multidisciplinary healthcare teams providing exceptional care to patients, serving in direct patient care, clinical research, patient education, nursing education, and advanced practice roles.