Nurse Telephone Follow-up Post Initial Chemotherapy: A Quality Improvement Project

With the evolution of cancer care and chemotherapy agents over the last 15 years there has been an evident shift in care from the inpatient to the ambulatory setting. There is a growing need for cancer care, particularly in the ambulatory (outpatient) setting. Patients receiving chemotherapy in the outpatient setting return home immediately after completing treatment and do not have direct medical and nursing supervision to monitor for and address side effects or adverse reactions of treatment in a hospital inpatient setting. Nurse telephone follow-up post initial chemotherapy allows for assessment and timely management of potential side effects experienced after the administration of chemotherapy in the outpatient setting. The purpose of this quality improvement project was to develop a standardized nurse telephone follow-up procedure post initial chemotherapy. The author developed an electronic script guideline and documentation tool along with a process for conducting the nurse-initiated calls. The project design included an educational activity and a post evaluation of the telephone follow-up procedure. Fifteen biotherapy/chemotherapy nurses participated in a four week pilot. During the four week pilot period 14 out of 34 first time chemotherapy patients received telephone follow-up utilizing the script guidelines. Ten nurses (N=10, 67%) completed the post evaluation survey. Results indicated that overall the script guidelines for telephone follow-up post initial chemotherapy was well received by staff and utilized appropriately. Replication of this project should include examining the impact of telephone follow-up on patient satisfaction and outcomes. The APRN is essential in promoting evidence-based practice and bringing it into the daily practices of staff nurses to improve the quality of care for patients and their families