Congress Abstracts 2006

134

INCORPORATING THE RISK FACTORS FOR CANCER- AND CANCER TREATMENT-RELATED SYMPTOMS INTO AN ELECTRONIC ASSESSMENT TOOL: MORE GAIN, LESS PAIN FOR ONCOLOGY NURSES AND THEIR PATIENTS. Nancy L. Henderson, RN, BSN, OCN^®, and Mary Lynne Mundo, RN, BSN, OCN^®, West Michigan Cancer Center, Kalamazoo, MI.

The Patient Encounter is a computer-assessment tool that was designed by a multi-disciplinary group of oncology nurses at our community cancer center to monitor patients during their treatment for cancer. It has a two-fold purpose: (1) to record symptom and symptom-management information; (2) to obtain patient outcomes. The Patient Encounter is divided into evidence-based groups for assessments that include pain, nausea and vomiting, fatigue, anemia, and neutropenia. In 2005, the Centers for Medicare and Medicaid Services (CMS) initiated a demonstration project aimed at improving the management of pain, nausea and vomiting, and fatigue. The nurses documenting these symptoms for the CMS observed that improvements could be made to the Patient Encounter to make patient outcomes readily available for nurses and other health personnel. This would enable better communication between medical personnel and optimize the management of our patients.

(1)To evaluate the management of fatigue, pain, and nausea. (2)To improve the management of our patients by incorporating risk assessments and interventions for these symptoms into the Patient Encounter.

We performed a retrospective chart review of Medicare patients receiving chemotherapy and evaluated how well we managed fatigue, pain, and nausea. The 3 symptoms were assessed using the CMS 4-point scale: 0(not at all), 1(a little), 2(quite a bit), and 3(very much).

Fifty-eight percent of patients with fatigue, 75% of patients with pain, and 87% of patients with nausea reported scores between 0 and 2.

The management of pain and nausea in older patients attending our cancer center is good. However, 42% of these patients reported severe fatigue, and the management of fatigue in these older patients required improvement. Our goal is to incorporate the National Comprehensive Cancer Network (NCCN) risk assessments and required interventions for cancer-related fatigue and anemia into the Patient Encounter. This will enable oncology nurses to identify patients with anemia-associated fatigue who may benefit from erythropoietic therapy. In the long-term, we aim to include risk assessments and interventions for other symptoms, such as neutropenia, into the Patient Encounter.