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

Autor: Lorraine Martelli, M. Vickers, Meg Carley, F. Kelly, Lisa Rambout, Craig Kuziemsky, Katelyn Balchin, Lynne Jolicoeur, Lindsay A. Jibb, Dawn Stacey, Claire Ludwig, Suzanne Madore
Rok vydání: 2020
Předmět:
Zdroj: Supportive Care in Cancer. 29:841-849
ISSN: 1433-7339
0941-4355
DOI: 10.1007/s00520-020-05551-5
Popis: To determine the quality of cancer symptom management when evidence from clinical practice guidelines are used in telephone-based oncology nursing services. 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. 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. 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: OpenAIRE
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