Date of Award

Spring 5-28-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Kevin Maxwell PhD, DNP, FNP-BC

Abstract

Introduction: Antineoplastic therapy initiation is linked to disease onset, recurrence, or progression. This stressful environment interferes with patients’ retention of treatment-related side effects and safety protocols. The ambulatory setting makes this especially challenging where return visit ranges from 8 to 28 days after treatment. During this time, patients are at risk for treatment related toxicities or developing questions related to symptoms. Using John Hopkin’s Evidence Based Project Model, a post-treatment telephone encounter was implemented. The goal was to reinforce clinic education and improve patient satisfaction.

Methods: Telephone follow up was initiated 24 to 48 hours after the initial infusion. Pre-intervention patient knowledge was assessed utilizing a ten item Leuven’s Questionnaire which measures patient’s understanding of treatment goals, administration schedule, potential side effects, and triaging resources. During the interview, a Registered Nurse reinforced treatment-related education, reviewed notification parameters, and coordinated appropriate follow up. Post interview, a second Leuven’s Questionnaire and patient satisfaction survey were emailed to participants.

Results: Mean pre-intervention Leuven’s Questionnaire score was 5.3 and a mean post-intervention Leuven’s Questionnaire score was 8.1 on a 1-10 scale (n= 31). A paired t-test was calculated with a p-value < 0.0001. Patients reported increased satisfaction after the intervention (n=30).

Discussion: Evidence supports the preemptive use of telephonic follow up for post-discharge and post-operative patients. However, gaps in the literature exist for proactive triage and education reinforcement in patients initiating antineoplastic treatments. This pilot exemplified significant improvement in patient’s education retention as well as satisfaction with their care. Future goals include expansion throughout a multi-disciplinary cancer center.

Clinical Implications: Introducing an evidence-based measure to patients initiating antineoplastic treatment is a cost-effective intervention which improves outcomes. The data demonstrated telephonic follow up after initial antineoplastic treatment improved patient education retention and satisfaction. This increased patient understanding led to earlier symptom recognition, expedient symptom management interventions, and ultimately prevented unnecessary treatment-related hospital admissions

Keywords: Patient education, knowledge, chemotherapy, immunotherapy, telephonic follow up

Available for download on Friday, May 10, 2024

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