整合以app为主导的支持性和姑息性肿瘤治疗项目:质量改进项目。

Cecilia Motschenbacher, Tanya Cohn
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引用次数: 0

摘要

发现晚期癌症患者在诊断时表现出严重的症状和低质量的生活;因此,至关重要的是,他们在连续的护理过程中尽早获得姑息治疗服务。肿瘤学高级实践提供者是唯一准备作为冠军的初级姑息治疗整合在他们的实践。这个质量改进项目的目的是在常规癌症治疗中开发和实施一个由app主导的支持性和姑息性肿瘤治疗(SPOC)项目。项目设计采用计划-执行-研究-行动(PDSA)方法作为SPOC项目开发、实施和分析的指导框架。在49名参与者中,在研究期间共有239次SPOC遭遇。参与者平均使用APP就诊4.9次(SD = 3.5)。患者报告的症状负担非常普遍,其中最常见的包括疼痛44例(90%),疲劳36例(74%),食欲不振29例(59%)和虚弱27例(55%)。94%的参与者(n = 46)在参与该计划期间与APP进行了结构化和记录的护理目标对话。共有7名患者在接受SPOC护理时完成了他们的预先指示,完成率为25%。对跨学科资源的需求显著(n = 136)。将SPOC原则整合到常规肿瘤学实践中是一个改善患者和家庭体验的机会,同时也展示了app在临床和组织层面的价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Integration of an APP-Led Supportive and Palliative Oncology Care Program: A Quality Improvement Project.

Integration of an APP-Led Supportive and Palliative Oncology Care Program: A Quality Improvement Project.

Integration of an APP-Led Supportive and Palliative Oncology Care Program: A Quality Improvement Project.

Integration of an APP-Led Supportive and Palliative Oncology Care Program: A Quality Improvement Project.

Patients with advanced cancer have been found to demonstrate severe symptoms and low quality of life at diagnosis; therefore, it is imperative that they have early access to palliative care services along the continuum of care. Oncology advanced practice providers are uniquely poised to serve as champions for primary palliative care integration within their practice. The purpose of this quality improvement project was to develop and implement an APP-led supportive and palliative oncology care (SPOC) program within routine cancer care. The project design utilized the Plan-Do-Study-Act (PDSA) methodology as the guiding framework for development, implementation, and analysis of the SPOC program. Across 49 participants, there were a total of 239 SPOC encounters during the studied period. Participants had a mean of 4.9 visits (SD = 3.5) with the APP. There was a high prevalence of patient-reported symptom burden, the most frequent of which included pain at 44 (90%), fatigue at 36 (74%), appetite loss at 29 (59%), and weakness at 27 (55%) instances. Ninety-four percent of participants (n = 46) had a structured and documented goals of care conversation with the APP during their participation within the program. A total of seven patients completed their advance directives while receiving SPOC care, which was a 25% completion rate. There was a significant demand for interdisciplinary resources (n = 136). Integration of SPOC principles into routine oncology practice is an opportunity to improve the patient and family experience while demonstrating the value of APPs at the clinical and organizational level.

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