The Children’s Oncology Group (COG) provided guidelines for parental education to support patients and families of children with newly diagnosed cancer. Researchers evaluated implementation of these recommendations in a study published in the Journal of Pediatric Hematology/Oncology Nursing and found that parent-based outcomes showed little change, but nurse satisfaction was significantly improved with the intervention.
“This study addresses an issue of vital importance to the field of pediatric oncology nursing,” the researchers wrote in their report.
In this study, the researchers evaluated a nurse-led Structure Discharge Teaching Intervention (SDTI) at a tertiary children’s hospital. Study participants included registered nurses and nurse practitioners in pediatric oncology units and parents of children with newly diagnosed cancer who had been admitted into an inpatient oncology unit for initial chemotherapy.
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The SDTI was used to implement COG-based recommendations for a variety of elements of education delivery, and nurses received training related to the intervention. Prior to SDTI implementation, parent education was conducted by either a pediatric oncology nurse educator, a nurse practitioner, or both, with staff nurses playing only a limited role. One example of a change introduced by the SDTI was to expand training in education delivery across members of the health care team.
The researchers assessed several outcomes in this study, including the parent Readiness for Hospital Discharge Scale (RHDS), the Quality of Discharge Teaching Scale (QDTS), the Post-Discharge Coping Difficulty (PDCD) tool, the Nurse Satisfaction tool, and the rate of postdischarge unplanned healthcare utilization.
Parents were assigned to an intervened cohort (52 parents) or an unintervened cohort (53 parents). A total of 126 nurses participated.
Overall, significant changes were made in the discharge education process with implementation of the SDTI. Discharge training took place in 1 day for 98.0% of parents in the unintervened cohort, compared with only 34.6% in the intervened cohort (P <.001). Parents in the intervened cohort more often received training over multiple days.
Most (98.0%) parents in the unintervened cohort had only 1 nurse involved in training per parent, whereas 80.8% of parents in the intervened cohort had more than 1 nurse involved in their training (P <.001). Additionally, the proportion of staff nurses involved in discharge training rose from 0.0% in the unintervened cohort to 86.5% in the intervened cohort (P <.001).
Parents demonstrated high scores on the RHDS and the QDTS in both the unintervened and intervened cohorts, and they also showed similar PDCD results at 2 weeks and 30 days after discharge in each cohort. Unplanned healthcare encounters occurred in approximately 60% of patients (48% in the unintervened cohort and 71% in the intervened cohort; P =.016), 69% of which were nonpreventable. However, nurses demonstrated significantly higher scores regarding multiple aspects of nurse satisfaction after the intervention.
The researchers concluded that the delivery of discharge education had changed significantly, but that parental assessments of their readiness and quality of discharge training were high before and after the intervention. However, nurse satisfaction showed significant improvement regarding the quality and process of discharge education.
Reference
Landier W, York JM, Bhatia S, et al. A structured discharge education intervention for parents of newly diagnosed pediatric oncology patients. J Pediatr Hematol Oncol Nurs. Published online January 18, 2023. doi:10.1177/27527530221140058
