2.50
Hdl Handle:
http://hdl.handle.net/10755/162666
Type:
Presentation
Title:
Recognizing Oncology Crises: A Staff-Driven Improvement Process
Abstract:
Recognizing Oncology Crises: A Staff-Driven Improvement Process
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Nolan, Mary-Beth, RN, MSN, CEN
P.I. Institution Name:Middlesex Hospital
Title:Emergency Department Educator
Contact Address:28 Crescent St., Middletown, CT, 06457, USA
Contact Telephone:(860) 358-4957
Co-Authors:Lisa Cull, RN, BS, OCN; Jacquelyn Calamari, RN, MS, CEN; Anne Campbell-Maxwell, RN, BSN, MBA; Katherine Palaski, RN; Cindy Marotta, RN
[Clinical Poster] Clinical Topic: Increasingly, oncology patients present to the emergency department seeking care during their disease continuum. Knowledge of new treatment modalities as well as astute assessment skills to recognize a related host of symptoms and side effects are now critical competencies for safe emergency management of these patients. Specialized care for cancer-related emergencies has evolved as a hybrid of oncology and emergency medicine. The purpose of this clinical project was to use an evidence-based, interdisciplinary approach to improve the quality of emergency oncology patient care through collaboration, education, resource support, and creation of best practice protocols.

Implementation: An interdepartmental project team comprised of nursing staff, managers, and nurse educators from both the emergency department and the cancer center examined current care practices, accessible resources, available education, current literature and patient outcomes to determine the quality of emergency oncology care. A number of areas were identified in which patient management could be improved. Over a six-month period, March - September 2006, the project team developed improvement initiatives aimed at maximizing the management of oncology emergencies. These initiatives included: (1) the development and presentation of "Just the Facts - Oncology Emergencies" as a three-day educational series. The initial course was offered in September of 2006. The series provided an overview of cancer pathophysiology, treatment modalities, pain management and frequently encountered oncologic emergencies. Oncology critical thinking skills were enhanced with analysis of case studies at the end of each class. The course is offered biannually and awards 10 continuing education units. The course was offered to the emergency department, inpatient, and home care nurses; (2) the design and implementation of a "Vital Oncology Facts" guide. This guide was placed in the triage reference manuals in September of 2006. Pocket versions of the guide were distributed to staff at the educational series and at department staff meetings; (3) standardization of the triage process. The oncology patient is triaged as a high-risk patient as appropriate. Proper room and nurse assignment are considered; (4) the enhancement of the ED's reference libraries with the addition of two new oncology resources.

Outcomes: This collaborative initiative achieved outcomes in three domains: (1) enhanced nursing staff competency and confidence in oncology emergency care. This was evident in both staff feedback as well as retrospective case review. Oncology series evaluation forms reflected many positive comments. Concurrent case review reveals critical thinking, process improvement, and enhanced patient outcomes; (2) improved time to treatment with the oncology patient identified as high-risk. Retrospective case review for appropriate triage risk yielded a pre-implementation score of 80% with improvement to 95% post-implementation. Patient presentation to bed placement time decreased by 50%; (3) expanded network of oncology care collaboration across outpatient, inpatient, and emergency care settings in order to standardize best care practices. At present, a multidisciplinary task force is formalizing a neutropenic pathway that spans the oncology care continuum from admission to discharge.

Recommendations: The project team advocates several initiatives. At the forefront is the implementation of a formal oncology-emergency core course for all emergency department providers including nurses, patient care technicians, paramedics and physicians. The successful management of the oncology patient is an interdisciplinary process. Therefore, we advise the formalization of a multidisciplinary task force, the goal of which should be the development of staff education, practice protocols/pathways and outcomes management. Lastly, the project team encourages on-going research focusing on oncology specific measurement outcomes, staff competency and existing protocols/pathways.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRecognizing Oncology Crises: A Staff-Driven Improvement Processen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162666-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Recognizing Oncology Crises: A Staff-Driven Improvement Process</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Nolan, Mary-Beth, RN, MSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Middlesex Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Emergency Department Educator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">28 Crescent St., Middletown, CT, 06457, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(860) 358-4957</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">MaryBeth_Nolan@MidHosp.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Lisa Cull, RN, BS, OCN; Jacquelyn Calamari, RN, MS, CEN; Anne Campbell-Maxwell, RN, BSN, MBA; Katherine Palaski, RN; Cindy Marotta, RN</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: Increasingly, oncology patients present to the emergency department seeking care during their disease continuum. Knowledge of new treatment modalities as well as astute assessment skills to recognize a related host of symptoms and side effects are now critical competencies for safe emergency management of these patients. Specialized care for cancer-related emergencies has evolved as a hybrid of oncology and emergency medicine. The purpose of this clinical project was to use an evidence-based, interdisciplinary approach to improve the quality of emergency oncology patient care through collaboration, education, resource support, and creation of best practice protocols.<br/><br/>Implementation: An interdepartmental project team comprised of nursing staff, managers, and nurse educators from both the emergency department and the cancer center examined current care practices, accessible resources, available education, current literature and patient outcomes to determine the quality of emergency oncology care. A number of areas were identified in which patient management could be improved. Over a six-month period, March - September 2006, the project team developed improvement initiatives aimed at maximizing the management of oncology emergencies. These initiatives included: (1) the development and presentation of &quot;Just the Facts - Oncology Emergencies&quot; as a three-day educational series. The initial course was offered in September of 2006. The series provided an overview of cancer pathophysiology, treatment modalities, pain management and frequently encountered oncologic emergencies. Oncology critical thinking skills were enhanced with analysis of case studies at the end of each class. The course is offered biannually and awards 10 continuing education units. The course was offered to the emergency department, inpatient, and home care nurses; (2) the design and implementation of a &quot;Vital Oncology Facts&quot; guide. This guide was placed in the triage reference manuals in September of 2006. Pocket versions of the guide were distributed to staff at the educational series and at department staff meetings; (3) standardization of the triage process. The oncology patient is triaged as a high-risk patient as appropriate. Proper room and nurse assignment are considered; (4) the enhancement of the ED's reference libraries with the addition of two new oncology resources.<br/><br/>Outcomes: This collaborative initiative achieved outcomes in three domains: (1) enhanced nursing staff competency and confidence in oncology emergency care. This was evident in both staff feedback as well as retrospective case review. Oncology series evaluation forms reflected many positive comments. Concurrent case review reveals critical thinking, process improvement, and enhanced patient outcomes; (2) improved time to treatment with the oncology patient identified as high-risk. Retrospective case review for appropriate triage risk yielded a pre-implementation score of 80% with improvement to 95% post-implementation. Patient presentation to bed placement time decreased by 50%; (3) expanded network of oncology care collaboration across outpatient, inpatient, and emergency care settings in order to standardize best care practices. At present, a multidisciplinary task force is formalizing a neutropenic pathway that spans the oncology care continuum from admission to discharge. <br/><br/>Recommendations: The project team advocates several initiatives. At the forefront is the implementation of a formal oncology-emergency core course for all emergency department providers including nurses, patient care technicians, paramedics and physicians. The successful management of the oncology patient is an interdisciplinary process. Therefore, we advise the formalization of a multidisciplinary task force, the goal of which should be the development of staff education, practice protocols/pathways and outcomes management. Lastly, the project team encourages on-going research focusing on oncology specific measurement outcomes, staff competency and existing protocols/pathways.</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:05Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:05Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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