Implementing Standards of Care in Radiation Dermatitis Prevention

Anna Skripnik Lucas, M.S.N., RN, DNC, FNP-BC, and Mario Lacouture, M.D. - PHOTOS BY KESHA LAMBERT

I am a dermatologist at Memorial Sloan Kettering Cancer Center (MSKCC) and have worked with Anna in the service for five years. Anna is a conscientious, driven and hardworking individual who continually strives for excellence in patient care and health care process improvement. She is an active leader who always seeks ways to create new opportunities. She recently implemented the first standards of care on radiation and prevention in post-mastectomy breast cancer patients receiving radiation therapy and breast cancer patients receiving proton therapy. As chair of the Radiation Dermatitis Prevention Task Force, Anna spearheaded this project to improve skin adverse events related to radiation therapy. These standards are the first of their kind to come out of the Dermatology Department as well as at our institution.

Approximately 87 to 95 percent of patients receiving radiation therapy to the breast will experience some degree of radiation dermatitis, and implementation of these standards of care will improve patients’ quality of life and tolerance of anticancer therapy, and alleviate the psychosocial burden of skin adverse events. Anna is an avid patient advocate; she presented the proposed standards of care to the chief medical officer and chief nursing officer of MSK, and is setting up measuring parameters to ensure that standards of care will be adhered to. Anna is also the principal investigator on a quality improvement project at MSKCC on evaluating the impact of radiation dermatitis on patients’ quality of life.

Among her many accomplishments, she has earned two bachelor’s degrees and a master’s degree in nursing practice, holds a national dermatology nursing certification and is a certified family nurse practitioner through the American Nurses Credentialing Center. Anna is following the Institute of Medicine’s recommendation for the future of nursing by achieving the highest level of education in doctorate of nursing practice at Duke University, and is due to graduate this year. She is a prime example of nursing excellence. Working with Anna on a daily basis, I am constantly impressed with her expertise and delivery of gold-standard care.

Anna has a special interest in improving cutaneous metastasis wound care and skin adverse events related to chemotherapy, radiation therapy and therapeutics. Anna presents her expertise related to management of palliative wound care of cutaneous manifestations, the role of oncodermatology nursing and management of skin side effects such as hair and nail changes, as well as radiation-plus-chemotherapy—induced skin toxicities. She has also been a mentor to medical students and has had abstracts accepted on anticancer therapy interruption and diagnostic concordance between referring clinicians and dermatologists at MSKCC.

Anna is an oncodermatology wound care nursing expert, and will be presenting at this year’s national Wound Ostomy and Continence Conference on cutaneous manifestations in the oncology population.

Additionally, she is chair of Wound Care in Oncology at the Multinational Association of Supportive Care in Cancer, and will present at this year’s international conference on management of malignant wounds. This is the first time someone has presented on this topic at this important meeting! Anna has created and been the point person on numerous institution-wide patient education materials. She is a hard-working, intelligent and thoughtful nurse, as well as a dedicated team leader who possesses a vast array of leadership skills. Anna is a consenting professional for multiple protocols for which I am a primary investigator. She places an emphasis on transforming oncologic care by utilizing current evidencebased research and translation into practice. Anna identifies patterns and trends related to the protocol, including skin adverse events, and collaborates with me to address these.

Anna’s leadership and professionalism are exceptional, and she is a truly outstanding individual.

She is systematic, yet creative, in her approach to patient care delivery, and uses her superior clinical judgment to tailor to the needs of each patient. It is clear that Anna continually strives to better herself as a nurse and contribute to the nursing discipline. Her dedication to improving patient care is extraordinary. I am delighted to be able to mentor Anna and recommend her for this award.