New Documentation Tool Improves Telephone Triage in Oncology Pain Management

A new pain assessment documentation tool is helping nurses in an ambulatory clinic better manage telephone triage in oncology care, according to a poster presented at the 2023 ONS Congress.

A standardized pain assessment template built into the electronic health record (EHR) improved communication across the health care team and better supported coordination of patient care compared with existing documentation tools, the study presenters indicated.

A team formed at an ambulatory clinic at Fred Hutchinson Cancer Center in Seattle, Washington, with the aim of standardizing pain assessment documentation in telephone triage. The team included professional practice coordinators, an advanced practice nurse, an EHR analyst, and nurses experienced in both telephone triage and pain management.

Guided by regulatory requirements, evidence-based standards, and staff input, the team created a new pain assessment template within the EHR. Among other questions, the template sought the following information:

• Location, pattern, and frequency of pain
• Clinical progression: when the pain started and whether it has changed over time
• Severity of pain according to a pain scale
• Whether the pain limits the patient’s daily activities
• What interventions have already been attempted
• What side effects, if any, the patient is experiencing from current pain medication
• Nurse’s recommendations for intervention and follow-up

The template also pulled information from Washington’s state prescription monitoring program (PMP) for each patient to aid in safe prescribing of opioids. To assist in implementation of the template, a tip sheet was created and distributed to nursing staff.

Nurses at the cancer center reported that the new template prevented them from missing required components of pain assessments during telephone triage, assisted in standardizing language across the organization, improved communication among multidisciplinary team members, and helped support longitudinal care coordination.

The presenters concluded that these pain assessment measures provide a foundation for an ongoing project to improve pain management for cancer patients at Fred Hutchinson, which they hope will lead to improved patient education and to decreases in emergency room visits due to pain.

Reference
McMahon E, Clements S, Leptich K. Supporting cancer pain management through standard nursing documentation in an ambulatory setting. ONS Congress 2023. April 26-30, 2023. Abstract P277.