Reducing Emergency Department Visits in Patients Receiving Anti-Neoplastic Therapy
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
The incidence of cancer increases annually with associated increases in frequency of therapies. Improvements have been made toward symptom management, yet symptoms requiring healthcare support remain prevalent. Patients experiencing toxicities associated with anti-neoplastic therapy often seek treatment in the emergency department, resulting in unplanned hospitalizations. Impact of unplanned hospitalizations on the health system is significant, impacting throughput and creating capacity strain. The project objective is to decrease the number of patients who have received anti-neoplastic therapy within the previous 30 days that seek symptom management treatment in the emergency department. The secondary objectives are to increase use of standardized education for symptom management and increase use of an alternate care setting for patients receiving anti-neoplastic therapy. Evidence supports standardized patient education by nurses emphasizing symptoms that would necessitate a call to their provider. Patient education included availability of the Immediate Care Center (ICC) as an alternate care site. Laminated pocket cards provided to patients of when to call for early intervention and education on ICC use were created. Pre and post data collected demonstrated a 20% reduction in emergency department visits and a 15% increase in ICC visits for the patient population. These shifts in care delivery resulted in an estimated 2 million dollar reduction in healthcare costs. The ICC continues to successfully evolve as an alternate care location for oncology patients requiring symptom management. Standardized education provided by nurses on symptom management and use of the ICC is an important intervention that can positively improve outcomes for the patient and the health system.
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