Nurse-Led Outpatient Model of Care Program for Malignant Bowel Obstruction in Advanced Gynecological Cancer

By Dustin Samples - February 10, 2023

Approximately 25-60% of women diagnosed with gynecological cancer, especially ovarian cancer, will experience malignant bowel obstruction (MBO). Caused by “external compression or functional occlusion of the gastrointestinal tract from peritoneal carcinomatosis or tumor infiltration of bowel muscle/nerves,” MBO has a poor prognosis, with 1 study putting the median survival after diagnosis at 105 days.

Patients with MBO from gynecological cancer may experience obstruction at 1 or more sites, and they typically have multiple hospitalizations, which negatively impacts their quality of life. Obstruction leads to an inability to eat, vomiting, abdominal cramps, and distention.

To improve the quality of life for patients with MBO due to gynecological cancer, a team from multiple institutions in Toronto, Ontario, designed a study evaluating the impact of a proactive, nurse-led, outpatient model of care for MBO. The study results were published in the Journal of Nursing Care Quality.

The MBO model of care utilized a risk-based algorithm and an interdisciplinary care team. It included:

  • Standardized tools
  • Risk-based assessment
  • Management strategies
  • Education for patients and nurses

After implementing their MBO model of care, the study team reported “improved patient-reported confidence level of bowel self-management and decreased hospitalization.” They added that, “Following education, nurses demonstrated increased knowledge in MBO management.”

The team concluded that an outpatient, nurse-led model of care for MBO management was useful and improved care. They also suggested that other institutions should utilize this model when caring for patients with gynecological cancers.


Malignant bowel obstruction in advanced gynecologic cancers: an updated review from a multidisciplinary perspective.

Malignant bowel obstruction due to uterine or ovarian cancer: are there differences in outcome?

Management of malignant bowel obstruction: an innovative proactive outpatient nurse-led model of care for patients with advanced gynecologic cancer.