Quality of telephone nursing services for adults with cancer and related non-emergent visits to the emergency department.

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  • Additional Information
    • Affiliation:
      Research Chair in Knowledge Translation to Patients Member, Royal Society of Canada's College Professor, School of Nursing, University of Ottawa Cross-Appointment, School of Epidemiology and Public Health, and Senior Scientist, Ottawa Hospital Research Institute, Centre for Practice Changing Research, Ottawa, ON
      Clinical Manager Systemic Therapy, Regional Cancer Program, The Ottawa Hospital, Ottawa, ON K1H 8L6
      Business Leader, Program Manager, Blood and Marrow Transplant Program, Regional Cancer Program, The Ottawa Hospital, Ottawa, ON
      Clinical Manager, TOHCC Clinics & New Patient Registration, The Ottawa Hospital, Ottawa, ON
      PhD candidate, School of Nursing, Faculty of Health Sciences, University of Ottawa, Roger Guindon Hall, Ottawa, ON
      Research Coordinator, Ottawa Hospital Research Institute, Centre for Practice Changing Research, Ottawa, ON
      Assistant Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
      Child Health Evaluative Sciences, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON
      Associate Vice-President, Research, MacEwan University, Edmonton, AB
      Clinical Director, Perioperative Services, Eye Care Program and Chronic Pain, The Ottawa Hospital, Ottawa, ON
      Oncology Professional Practice Coordinator, Pharmacy, The Ottawa Hospital, Ottawa, ON
      Oncology Nurse, The Ottawa Hospital, Ottawa, ON
      Physician, Medical Oncology, The Ottawa Hospital, Ottawa, ON
      Provincial Head-Cancer Nursing, Cancer Care Ontario, Toronto, ON
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      A quality improvement project was conducted to determine the quality of telephone nursing for patients with cancer symptoms. Eligible patients were ones who telephoned the nurse about cancer symptom(s) within four weeks prior to an emergency department (ED) visit not requiring hospital admission. Experienced oncology nurses extracting data indicated appropriateness of ED visits and opportunities for improvement. The Symptom Management Analysis Tool was used to analyze nurse documentation. For 77 patients, 87% ED visits occurred within four days of calls about symptoms (e.g., pain, breathlessness, constipation, diarrhea, nausea/vomiting) and 91% could have been managed by more complete telephone assessment and/or an urgent clinic visit. Quality of nurse documentation revealed few patients were assessed adequately (38%), received any symptom-specific medication review (49%), or were guided in self-care strategies (17%). There was low-quality telephone symptom management by nurses and a need for alternative options for patients requiring urgent face-to-face assessments. Our findings highlight a gap in use of guidelines for informing telephone symptom management.
      Un projet d'amélioration de la qualité a été mené afin de mesurer la qualité des interventions téléphoniques des infirmières auprès des patients présentant des symptômes associés au cancer. Les patients admissibles au projet avaient téléphoné à une infirmière pour signaler des symptômes dans les 4 semaines précédant une visite aux urgences qui n'avait pas requis d'hospitalisation. Les infirmières spécialisées en oncologie qui ont extrait les données évaluaient la pertinence des visites aux urgences et les points à améliorer. Nous avons eu recours à un outil d'analyse de la gestion des symptômes pour analyser la documentation du personnel infirmier. Sur 77 patients, 87 % des visites aux urgences ont eu lieu durant les 4 jours suivant un appel téléphonique justifié par la présence de symptômes (douleur, dyspnée, constipation, diarrhée, nausées ou vomissements, etc.). Dans 91 % des cas, une évaluation téléphonique plus exhaustive ou une consultation dans une clinique de soins d'urgence aurait suffi. Selon la documentation laissée par les infirmières, peu de patients ont été évalués adéquatement (38 %), ont bénéficié d'une révision de la médication traitant leurs symptômes (49 %) ou ont reçu des conseils sur les stratégies de soins autoadministrés (17 %). La qualité de la prise en charge des symptômes effectuée au téléphone par les infirmières laissait à désirer et il aurait fallu trouver des solutions de rechange pour les patients nécessitant une évaluation d'urgence en personne. Ces constats font ressortir des lacunes dans l'utilisation des directives sur la gestion téléphonique des symptômes.
    • Journal Subset:
      Canada; Core Nursing; Nursing; Peer Reviewed
    • Instrumentation:
      Symptom Management Analysis Tool (SMAT)
    • ISSN:
      1181-912X
    • MEDLINE Info:
      NLM UID: 9300792
    • Publication Date:
      20200729
    • Publication Date:
      20200729
    • DOI:
      10.5737/23688076303193199
    • Accession Number:
      144611142
  • Citations
    • ABNT:
      STACEY, D. et al. Quality of telephone nursing services for adults with cancer and related non-emergent visits to the emergency department. Canadian Oncology Nursing Journal, [s. l.], v. 30, n. 3, p. 193–207, 2020. DOI 10.5737/23688076303193199. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=144611142. Acesso em: 25 set. 2020.
    • AMA:
      Stacey D, Jolicoeur L, Balchin K, et al. Quality of telephone nursing services for adults with cancer and related non-emergent visits to the emergency department. Canadian Oncology Nursing Journal. 2020;30(3):193-207. doi:10.5737/23688076303193199
    • APA:
      Stacey, D., Jolicoeur, L., Balchin, K., Duke, K., Ludwig, C., Carley, M., Jibb, L., Kuziemsky, C., Madore, S., Rambout, L., Romanick, J., Vickers, M. M., & Martelli, L. (2020). Quality of telephone nursing services for adults with cancer and related non-emergent visits to the emergency department. Canadian Oncology Nursing Journal, 30(3), 193–207. https://doi.org/10.5737/23688076303193199
    • Chicago/Turabian: Author-Date:
      Stacey, Dawn, Lynne Jolicoeur, Katelyn Balchin, Kate Duke, Claire Ludwig, Meg Carley, Lindsay Jibb, et al. 2020. “Quality of Telephone Nursing Services for Adults with Cancer and Related Non-Emergent Visits to the Emergency Department.” Canadian Oncology Nursing Journal 30 (3): 193–207. doi:10.5737/23688076303193199.
    • Harvard:
      Stacey, D. et al. (2020) ‘Quality of telephone nursing services for adults with cancer and related non-emergent visits to the emergency department’, Canadian Oncology Nursing Journal, 30(3), pp. 193–207. doi: 10.5737/23688076303193199.
    • Harvard: Australian:
      Stacey, D, Jolicoeur, L, Balchin, K, Duke, K, Ludwig, C, Carley, M, Jibb, L, Kuziemsky, C, Madore, S, Rambout, L, Romanick, J, Vickers, MM & Martelli, L 2020, ‘Quality of telephone nursing services for adults with cancer and related non-emergent visits to the emergency department’, Canadian Oncology Nursing Journal, vol. 30, no. 3, pp. 193–207, viewed 25 September 2020, .
    • MLA:
      Stacey, Dawn, et al. “Quality of Telephone Nursing Services for Adults with Cancer and Related Non-Emergent Visits to the Emergency Department.” Canadian Oncology Nursing Journal, vol. 30, no. 3, Summer 2020, pp. 193–207. EBSCOhost, doi:10.5737/23688076303193199.
    • Chicago/Turabian: Humanities:
      Stacey, Dawn, Lynne Jolicoeur, Katelyn Balchin, Kate Duke, Claire Ludwig, Meg Carley, Lindsay Jibb, et al. “Quality of Telephone Nursing Services for Adults with Cancer and Related Non-Emergent Visits to the Emergency Department.” Canadian Oncology Nursing Journal 30, no. 3 (Summer 2020): 193–207. doi:10.5737/23688076303193199.
    • Vancouver/ICMJE:
      Stacey D, Jolicoeur L, Balchin K, Duke K, Ludwig C, Carley M, et al. Quality of telephone nursing services for adults with cancer and related non-emergent visits to the emergency department. Canadian Oncology Nursing Journal [Internet]. 2020 Summer [cited 2020 Sep 25];30(3):193–207. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=144611142