ANAHEIM, CALIFORNIA—Patient anxiety was decreased and satisfaction increased by a pretreatment educational telephone call to patients before they begin outpatient chemotherapy, according to a report on a pilot program presented at the Oncology Nursing Society (ONS) 39th Annual Congress.
Many patients new to chemotherapy patients wait a week or more between when their physician presents their chemotherapy plan and when they arrive at the infusion room for therapy. In the meantime, they developed anticipatory anxiety. In addition, their chemotherapy plans did not include crucial information about the infusion room experience. Patients came to the infusion room unprepared for their first treatment.
Denise Fleming, RN, BSN, OCN®, and Ruth Pina, RN, BSN, OCN®, and colleagues at the University of California Davis Health System, Comprehensive Cancer Center, Sacramento, designed and implemented a nursing pretreatment educational telephone call with the goal of improving patient satisfaction and unit efficiency.
Patients should know about the length of treatment, infusion room expectations, the need to prehydrate, and to bring their chemotherapy-related medications with them. “Anxiety is the enemy of cognition,” stated Fleming. Patients also need to be told about food, guests, parking, and other information. This lack of information for first infusion appointments led to prolonged teaching time, negatively impacting unit efficiency and decrease patient and nurse satisfaction. Nurses were using chemotherapy teaching time to resolve preventable problems and conflicts.
A call template was developed that provided the nurse making the call with a script to follow such as, “Hello Mrs. Smith. I am Jane, a nurse at the Cancer Center. I see you have an appointment at the infusion clinic tomorrow. …” The calls helped identify barriers to care and prevented same-day cancellations, patients were informed and receptive, and treatment times were shortened. Other benefits included identifying treatment obstacles and scheduling conflicts to allow for preemptive planning.
Patients who received a pretreatment call during a 1-month period were asked to complete a survey on the experience. The survey was completed by 19 patients, providing feedback on the pretreatment call. All 19 respondents reported increased satisfaction and reduced anxiety. The patients reported increased feelings of control and confidence, they valued having realistic expectations, and they appreciated the preestablished relationship on their first day of treatment.
The nurses found that patients were more receptive to teaching and had shortened length of stays because the patients were more prepared upon arrival. The program improved clinic efficiency and set the stage for success in the first encounter between the patient and the nurse. It has been expanded to include nonchemotherapy patients.
Fleming D, Pina R. Before we begin: Does a pre-treatment education phone call increase satisfaction for the new outpatient chemotherapy patient? Presented at: Oncology Nursing Society (ONS) 39th Annual Congress, May 1-5, 2014; Anaheim, CA.