Alisha Bruner, a registered nurse at Akron Children’s Hospital, focused her Doctor of Nursing Practice project on using oral cryotherapy to help reduce mucositis in pediatric oncology patients, according to an April 30 announcement. Mucositis is a painful condition caused by certain chemotherapy agents that affects the lining of the gastrointestinal tract and can make it difficult for young patients to eat or drink.
The issue is significant because mucositis is one of the most common and debilitating side effects for children undergoing chemotherapy. It often leads to additional complications and prolonged hospital stays.
Bruner said she was inspired by her experiences on the hematology oncology unit, where she saw firsthand how much this condition impacted children. She explained, “These are patients who are already vulnerable. Mucositis creates new complications.” Research indicates that oral cryotherapy—using ice chips or cold liquids during chemotherapy infusions—can lower both the incidence and severity of mucositis by constricting blood vessels in the mouth and throat, thereby reducing exposure of tissues to chemotherapy.
To address this problem, Bruner worked with Dr. Mandi Cafasso, director of the Doctor of Nursing Practice program at University of Cincinnati and a nurse at Cincinnati Children’s Hospital. Together with colleagues at Akron Children’s Hospital, they developed an educational plan aimed at increasing nurses’ knowledge about mucositis and encouraging adherence to offering oral cryotherapy as an intervention.
Bruner said Dr. Cafasso played a key role: “Even though Dr. Cafasso may not know the nitty-gritty of pediatric hematology oncology, she was constantly asking ‘what can we do to make this better not only for your project, but for the patients as well.’” The intervention led to improved staff knowledge and implementation rates regarding oral cryotherapy among nurses caring for pediatric cancer patients.
As Bruner prepares for graduation from University of Cincinnati College of Nursing’s online DNP program—a path she chose partly due to its flexibility—she looks ahead toward expanding these efforts further: evaluating long-term retention among staff members across institutions and assessing direct patient outcomes through digital tools for data collection. “Oral cryotherapy is inexpensive, requires no specialized equipment, and involves no additional medications,” Bruner said. “Encouraging a patient to suck on ice chips during a chemotherapy infusion could mean fewer painful ulcers, fewer complications, and shorter hospital stays for some of the most vulnerable pediatric patients.”
Reflecting on her journey into nursing leadership through advanced education programs like UC’s DNP track—which allowed her flexibility while working—Bruner noted: “Being a leader as a nurse and being a leader in the nursing profession are two different things… But the DNP coursework showed me a bigger picture.”
