First Advisor

Dunemn, Kathleen

First Committee Member

Henry, Melissa L. M.

Second Committee Member

Pool, Natalie

Third Committee Member

Ma, Dalong

Degree Name

Doctor of Nursing Practice

Document Type

Scholarly Project

Date Created

12-1-2025

Department

College of Natural and Health Sciences, Nursing, Nursing Student Work

Abstract

Patients with hematologic malignancies such as leukemia, multiple myeloma, and lymphoma frequently undergo bone marrow aspiration and biopsy (BMAB) procedures throughout their treatment trajectory. At a comprehensive cancer research hospital in southern California, these procedures were commonly performed on an outpatient basis by nurse practitioners and physician assistants while patients remained awake under topical anesthesia. Despite these measures, patients consistently reported significant pain and anxiety during BMAB procedures (Glennon et al., 2018). Current literature supported the use of virtual reality (VR) as an effective non-pharmacologic intervention to reduce pain and anxiety in cancer populations (Ahmad et al., 2020). However, the institution did not have a standardized VR protocol in place for adult patients undergoing BMAB. The purpose of this DNP project was to develop and refine a VR practice protocol in collaboration with clinical experts and stakeholders at a comprehensive cancer hospital in Southern California, intended to be implemented it in the future for patients undergoing outpatient BMABs. The following research question guided this project

Q1 Can a review of the literature, combined with expert panel feedback, be used to develop and refine a VR protocol to reduce pain and anxiety in adult patients undergoing outpatient BMABs at a comprehensive cancer research hospital in Southern California?

Guided by the knowledge-to-action framework, this project involved a comprehensive literature review, protocol development, and expert panel validation using a SurveyMonkey questionnaire. Six hematology clinicians participated, providing both quantitative and qualitative iv feedback. Findings demonstrated 100% agreement regarding protocol feasibility, safety, and clarity, with suggested refinements implemented to enhance usability and integration. The finalized protocol provides a foundation for future pilot implementation to evaluate patient outcomes including pain, anxiety, and satisfaction.

Abstract Format

html

Keywords

Virtual reality; protocol development; bone marrow biopsy; bone marrow aspiration; hematologic malignancies; pain management; anxiety reduction

Language

English

Extent

81 pages

Rights Statement

Copyright is held by the author.

Digital Origin

Born digital

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