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A nurse-led telephone call intervention decreased emergency department (ED) visits and hospital admissions among patients with head and neck cancer (HNC) receiving radiation therapy. These findings were published in the Clinical Journal of Oncology Nursing.
Pain is reported to be the most debilitating side effect of treatment among patients with HNC. Unresolved and unmanaged pain can lead to ED visits and hospital admissions, among other complications.
This quality improvement project was conducted at the Vidant Radiation Oncology clinic in the United States. Patients with HNC who were receiving radiation therapy and were given a prescription for pain medication were contacted by a nurse 48 to 72 hours after their prescription distribution. During the telephone call, the nurses administered a 6-question assessment tool, and pain was scored on an 11-point Numeric Rating Scale (NRS). The outcomes of interest were the number of ED visits and hospital admissions. Outcomes were compared with those of patients treated before the project rollout.
The 11 patients treated before and 19 patients treated after the rollout were mean ages 66.8 and 62.7 years, 10 and 13 were men, and 6 and 17 were White, respectively.
A total of 10 telephone calls were made.
On the first day of treatment, the pre- and postintervention groups reported pain scores of 0.9 and 2.25 and on the last day, 5 and 6.25, respectively.
The rate of ED visits decreased from 36% to 26% and hospital admission rate from 27% to 16% from the preintervention to the postintervention periods.
The major limitation of this study was that only approximately half of the postintervention group was contacted by telephone.
The study author concluded, “By implementing a telephone care path to contact patients receiving radiation therapy and pain medication, nurses can more effectively assess and manage patients’ pain.”
Reference
McDuffie AL. Effects of a nurse-initiated telephone care path for pain management in patients with head and neck cancer receiving radiation therapy. Clin J Oncol Nurs. 2023;27(2):143-146. doi:10.1188/23.cjon.143-146
