Congress Abstracts 2006

319

USING THE AIM HIGHER PROCESS TO IMPLEMENT A MULTISYMPTOM PRECHEMOTHERAPY RISK ASSESSMENT TOOL. Jill Fallon, RN, CRNI, MSN, OCN^® , Eastern Connecticut Hematology and Oncology Associates, Norwich, CT; and Cathy Fortenbaugh, MSN, AOCN^® , Pennsylvania Oncology and Hematology Associates, Philadelphia, PA.

Patients being treated with chemotherapy are at risk of developing treatment-related symptoms. A proactive approach toward risk assessment can minimize or prevent many of these symptoms. Nurses in the AIM Higher Initiative developed a tool to assist clinicians in the identification of patients at the prechemotherapy stage who are at risk for multiple chemotherapy-related symptoms. This tool takes into account individual risk factors as well as those due to chemotherapeutic treatment. It also streamlines the assessment of the symptoms of chemotherapy, including anemia, neutropenia, nausea, vomiting, diarrhea, constipation, depression, anxiety, neurotoxicity, peripheral neuropathy, cardiac toxicity, hand-foot syndrome, and mucositis.

To describe how the AIM Higher process was used to successfully implement the risk assessment tool

The AIM Higher process involves 3 steps: analysis of the practice, development of a quality improvement plan, and implementation of that plan. Analyzing the practice and developing the plan entail deciding how and when the risk assessment tool will be used and who is responsible for collecting the information.

The risk assessment tool has been most effective in helping to achieve positive patient outcomes when it is used before the patient's first cycle of chemotherapy. Several AIM Higher practices implement the tool during their prechemotherapy class, allowing providers to both assess risk and teach patients how to be proactive in the management of their side effects. This is an important step, as the tool must be effectively implemented to ensure its usefulness. It is of note that the presence of >1 risk factor indicates that the patient may be at greater risk of developing symptoms and may require additional intervention, including customized patient education.