Quality of telephone-based cancer symptom management by nurses: a quality improvement project.

Autor: Stacey D; School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. dstacey@uottawa.ca.; Ottawa Hospital Research Institute, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada. dstacey@uottawa.ca., Ludwig C; School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada., Jolicoeur L; Regional Cancer Program, The Ottawa Hospital, Ottawa, Ontario, Canada., Carley M; Ottawa Hospital Research Institute, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada., Balchin K; Blood and Marrow Transplant Program, Regional Cancer Program, The Ottawa Hospital, Ottawa, Ontario, Canada., Jibb L; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada., Kelly F; University of Ottawa Heart Institute (Cardiac Virtual Care), Ottawa, Ontario, Canada., Kuziemsky C; MacEwan University, Edmonton, Alberta, Canada., Madore S; Eye Care Program, The Ottawa Hospital, Ottawa, Ontario, Canada.; Acute and Chronic Pain, Substance Use Program and Medical Device Reprocessing, The Ottawa Hospital, Ottawa, Ontario, Canada., Rambout L; Pharmacy, The Ottawa Hospital, Ottawa, Ontario, Canada., Vickers MM; Medical Oncology, The Ottawa Hospital, Ottawa, Ontario, Canada., Martelli L; Cancer Care Ontario, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2021 Feb; Vol. 29 (2), pp. 841-849. Date of Electronic Publication: 2020 Jun 04.
DOI: 10.1007/s00520-020-05551-5
Abstrakt: Purpose: To determine the quality of cancer symptom management when evidence from clinical practice guidelines are used in telephone-based oncology nursing services.
Methods: Guided by the Knowledge to Action Framework, we conducted a quality improvement (QI) project focused on "monitoring knowledge use" (e.g., use of practice guides) and "measuring outcomes." In 2016, 15 Pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) practice guides that synthesize evidence from guidelines were implemented with training for all oncology nurses at a regional ambulatory oncology program. Eighteen months post-implementation, Symptom Management Analysis Tool (SMAT) was used to analyze audio-recorded calls and related documentation of cancer symptom management.
Results: Of 113 audio-recorded calls, 66 were COSTaRS symptoms (58%), 43 other symptoms (38%), and 4 medically complex situations (4%). Of 66 recorded calls, 63 (95%) were documented. Average SMAT quality score was 71% (range 21-100%) for audio-recordings and 63% (range 19-100%) for documentation of calls. COSTaRS practice guide use was documented in 33% calls. For these calls, average SMAT quality scores were 74% with COSTaRS versus 69% without COSTaRS for audio-recording and 73% (range 33-100%) with COSTaRS versus 58% without COSTaRS for documentation. Patient outcomes indicated symptom was resolved (38%), worse (25%), unchanged (3%), or unknown (33%). Eight patients (13%) had an ED visit within 14 days post that was related to the symptom discussed.
Conclusions: Only a third of nurses indicated use of COSTaRS practice guides. There were higher quality symptom management scores when COSTaRS use was reported. Nurses documented less than what they discussed.
Databáze: MEDLINE
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