The Development of a Nursing Assessment and Symptom Management Clinic

Abstract

The Anne Arundel Medical Center (AAMC) DeCesaris Cancer Institute (DCI) began its participation in the ONS Foundation-supported Breast Cancer Care Quality Measures Set pilot study in 2010. The design and measures of the project were intriguing, paving a path for DCI to define quality measures and outcomes that were of value to the AAMC's oncology population and system. As the pilot program was getting underway, measurement instruments were selected for fatigue, distress, and sleep-wake disturbances. These were used as quality measures for care of patients receiving chemotherapy, to be reported to the Oncology Quality Council, AAMC DCI's Executive Quality Council, and the AAMC Board of Directors. Scores for these quality measures, as well as patient satisfaction scores for the Outpatient Infusion Center, have increased markedly since the 2010 pilot test. The increases in scores inspired nursing leadership, in conjunction with AAMC DCI's Medical Oncology Executive Committee, to develop an innovative nursing model, the advanced oncology nurse practitioner-led symptom management clinic, to systematically and efficiently treat the needs of patients with cancer.

Screening, evaluation, and management of cancer‐related fatigue: Ready for implementation to practice?

“…The cost of providing informal supportive care services is not quantified routinely, but clinicians are aware that poor fatigue management can lead to decreased satisfaction with care by both the patient and the caregiver. Severe fatigue also can lead to increased costs related to the number of telephone calls, clinic visits, and emergency room visits and delayed timing and dose of treatments . Teaching and reinforcing self‐management strategies to reduce fatigue and adopt healthy lifestyle behaviors early in the cancer treatment trajectory may result in reduced costs and numbers of survivors who report chronic fatigue and poor functioning.…”

“…Severe fatigue also can lead to increased costs related to the number of telephone calls, clinic visits, and emergency room visits and delayed timing and dose of treatments. 316 Teaching and reinforcing self-management strategies to reduce fatigue and adopt healthy lifestyle behaviors early in the cancer treatment trajectory may result in reduced costs and numbers of survivors who report chronic fatigue and poor functioning.…”

Stakeholder Perceptions of Key Aspects of High-Quality Cancer Care to Assess with Patient Reported Outcome Measures: A Systematic Review

“…Three additional US studies did not include patients. In a symptom management clinic, Graze et al discussed that high-quality nursing care delivery models include timely assessments for unmet needs and symptoms and effective symptom management for a variety of symptoms including distress and psychological symptoms [ 43 ]. Nelson et al interviewed nurses, nursing assistants, and administrators who noted patients with high levels of anxiety need more support from staff to achieve high-quality care [ 17 ].…”

“…In interviews and surveys with patients with diverse cancer types, Schulmeister noted the need for symptom management and supportive care services in the provision of high-quality care [ 44 ]. Graze et al developed a clinic led by advanced oncology nurses that specifically addressed symptom management to provide better care, and to reduce hospitalizations [ 43 ].…”

Fatigue and associated factors among adult cancer patients receiving cancer treatment at oncology unit in Amhara region, Ethiopia

“…Fatigue has a wide range of consequences, including disrupting physical, mental, economic, and social well-being as well as being a risk factor for decreased survival, with a strong positive association for all cancer-related mortality [26]. Untreated fatigue may result in decreased satisfaction for both the patient and the caregiver and lead to expanded costs related to a number of phone calls, clinic visits, and critical care room visits, as well as postponed timing and dose of treatments [27], dependency on others, loss of power over decision making, and daily living disruption [28]. Fatigue causes a reduction in survival and interferes with job, enjoyment of life, relationships, and motivation due to the cancer [29].…”