PILOTING A SELF-REPORTED SYMPTOM ASSESSMENT TOOL IN THREE OUTPATIENT ONCOLOGY PALLIATIVE CARE CLINICS Public Deposited

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  • March 2, 2021
Creator
  • Patel, Mallikaben
    • Affiliation: School of Nursing
Abstract
  • Objective: Describe the process of implementing Edmonton Symptom Assessment System -Revised (ESAS-r) with single-item quality of life (ESAS-r + 1 QoL) form into the three Oncology Clinics for all Outpatient Oncology Palliative Care (OOPC) patients.Background: Literature supports the high symptom burden experienced by oncology palliative care patients due to disease process and treatment side effects. Despite this, symptoms are often not screened sufficiently or consistently in the outpatient oncology palliative care setting.Aim Statement: The pilot project will help recognize barriers and facilitators to incorporating ESAS-r + 1 QoL form before implementing into the routine practice.Methods: To assess effective implementation of ESAS-r + 1 QoL form at each OOPC visit, four consecutive Plan-Do-Study-Act (PDSA) three-week cycles were performed. At the end of each PDSA cycle, barrier and facilitators were recognized by the DNP student and changes were made. The pilot project structure was based on the RE-AIM framework.Results: Effectiveness of the implementation was determined by percentage of adherence using following formula [(number of Esas-r +1 QoL forms completed per clinic / Number of OOPC completed patient appointments per clinic) X100]. A total of 372 patient appointments were completed during the pilot period, with overall 59% compliance to completing the ESAS-riv+1 QoL form. The first PDSA cycle compliance was 69%, 58% in second PDSA cycle, 52% in third PDSA cycle, and 65% in fourth PDSA cycle.Conclusion: We were able to implement ESAS-r + 1 QoL form in the complex clinical setting. Because of turnover in staff, we identified some barriers for sustainability. This will include robust instructions that provide a brief overview of the clinic workflow and education for all staff members involved in the implementation process. For future directions, we recommend integrating this form into the electronic medical record for monitoring of patient outcomes.
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Advisor
  • Bryant , Ashley
  • Mayer, Deborah
  • Winzelberg, Gary
Degree
  • Doctor of Nursing Practice
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2020
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