Improving Practice in a Head and Neck Oncology Clinic Using the PRO-CTCAE Tool

Rose Ann Ruddy, DNP, MSN, RN, ACNP-BC, Brigit Carter, PhD, RN, CCRN, FAAN, Maryanne Giuliante, DNP, MBA, RN, GNP, ANP-C, NEA-BC, HEC-C, AnnMarie Lee Walton, PhD, RN, MPH, OCN, CHES, FAAN
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Abstract

Background: Patients with head and neck cancer undergoing treatment report many side effects. Using patient-reported outcomes can assist with care management. Objectives: The purpose of this quality improvement project was to implement the patient-reported outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) measurement system, reduce patient hydration visits, and measure provider satisfaction with the PRO-CTCAE survey. Methods: Statistical analysis was conducted using IBM SPSS software. Descriptive statistics for means were used to summarize the data for survey completion rate and for the provider satisfaction questionnaire. A Fisher’s exact test was used to compare hydration visits before and after implementation of the PRO-CTCAE survey. Findings: The PRO-CTCAE surveys had a response rate of 91.2% (323/354) when telehealth visits were omitted. Hydration in the presurvey group was 23.5% (150/637) and in the postsurvey group was 38.5% (165/429), a 15% absolute percentage increase (Fisher’s exact p < .001). Among providers, the positive response rate was 100% for five questions and 88.9% for two questions. Implications: The PRO-CTCAE survey allowed the patient to report their symptoms prior to discussing them with their provider. Providers were able to expedite symptom management and get information to patients in a timely manner. The PRO-CTCAE survey should be considered a part of a multidisciplinary approach to caring for patients.
利用 PRO-CTCAE 工具改进头颈部肿瘤诊所的诊疗方法
背景正在接受治疗的头颈部癌症患者报告了许多副作用。利用患者报告的结果可以帮助进行护理管理。目标:本质量改进项目旨在实施患者报告结果版不良事件通用术语标准(PRO-CTCAE)测量系统,减少患者水化就诊次数,并测量医疗服务提供者对 PRO-CTCAE 调查的满意度。方法:使用 IBM SPSS 软件进行统计分析。使用均值描述性统计来总结调查完成率和医疗服务提供者满意度问卷的数据。费舍尔精确检验用于比较实施 PRO-CTCAE 调查前后的水合次数。调查结果:当忽略远程医疗访问时,PRO-CTCAE 调查的回复率为 91.2%(323/354)。调查前组的水合率为 23.5%(150/637),调查后组的水合率为 38.5%(165/429),绝对百分比增加了 15%(费雪精确检验 p < .001)。在医疗服务提供者中,5 个问题的正面回答率为 100%,2 个问题的正面回答率为 88.9%。意义:通过 PRO-CTCAE 调查,患者可以在与医疗服务提供者讨论之前报告自己的症状。医疗服务提供者能够加快症状管理并及时向患者提供信息。PRO-CTCAE 调查应被视为多学科患者护理方法的一部分。
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