Date of Award


Document Type


Degree Name

Doctor of Nursing Practice

Degree Discipline

Nursing Practice


Patients with cancer who undergo chemotherapy are at risk of immune system compromise. Fever in a patient with cancer who receives chemotherapy can indicate presence of an infection. In patients with a compromised immune system, an infection requires immediate further evaluation and management. Thus, patients receiving chemotherapy must understand when to notify physicians of a fever for prompt evaluation and management.

Purpose. This project aimed to increase the number of fevers gastrointestinal oncology patients receiving chemotherapy reported within 24 hours of detection to MyChart messaging, CareSense, or by calling the physician's office.

Methodology.All gastrointestinal oncology patients who underwent chemotherapy received a reporting fever instructional session by the nurse practitioner. They also received CareSense prompts via text message or email. New patients receiving chemotherapy were enrolled in CareSense at the same time the chemotherapy appointment was scheduled. Patients also received a CareSense handout and an after-visit summary. On days two and four post-chemotherapy, CareSense sent a text notification to ask the patient if they experienced a fever with a temperature ≥100.4°F. The patient’s selection of yes or no elicited a follow-up response. On day six post-chemotherapy, CareSense sent a patient satisfaction survey via text to assess whether the tool improved the patient's knowledge about chemotherapy and recovery and whether the reminders were helpful. Data related to patient-reported fever and patient satisfaction were collected for three months and then analyzed.

The project was designed to assess pre- and post-reporting effects of the fever instructional session and CareSense prompt notifications of fevers within 24 hours of detection using CareSense, MyChart messaging, or calls to the physician’s office. Fisher’s Exact Test of Independence was used to determine if there was an increase in the number of reported fevers following the intervention. The results were significant based on an alpha=.05 and a p-value <.001. This result suggested that post-intervention reporting fever instructional sessions and CareSense prompts were effective, with 100% compliance of patients reporting fevers within 24 hours of detection by calling the physician’s office.

Conclusion. The project provided beneficial information to practices using mobile health technology communication tools, such as CareSense, and a fever reporting session to improve optimal patient outcomes. This project also improved oncology patients receiving chemotherapy fever reporting within 24 hours to physicians to reduce lifethreatening complications and fatalities associated with fever.

Keywords: Gastrointestinal cancer, neutropenic fever, CareSense, fever instructional session, effects of messaging systems, chemotherapy

Committee Chair/Advisor

Chloe Gaines

Committee Co-Chair:

Stacy Sam

Committee Member

Ruby A. Benjamin-Garner

Committee Member

Jennifer Berry


Prairie View A&M University


© 2021 Prairie View A & M University

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Date of Digitization


Contributing Institution

John B Coleman Library

City of Publication

Prairie View





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