A structured self-reporting new patient assessment tool: Guide to oncology nursing practice

Abstract

Ambulatory nursing care of the patient with cancer presents unique challenges for the assessment, prevention and management of patient problems. In the ambulatory setting, the time available to teh nurs with each patient is limited, and nurses must have a strong knowledge base and keen assessment skills. Use of a structured, self-reporting assessment tool designed to tap the high incidence proglem areas for the oncology patient can facilitate effective and efficient data collection.

This type of tool was developed and piloted on 321 patients in the ambulatory area of a cancer referral centre. These patients were visiting the institution for the first time, and included patients who were newly diagnosed, patients who were seeking a second opinion, and patients requiring adjuvant therapy. Review of the pilot data revealed interesting trends regarding the prevalence of various problems or needs. The top problems pertained to the performance of activities of daily living (ADL) and included: Bending/lifting, sleeping, climbing stairs, walking or moving around, etc. Each of the ADLs were cited by at least 16-25% of the patients. Symptom management problems such as breathing, constipation, nausea etc. were each cited by less than 15% of the patients.

This paper describes the trends observed, the implications of the data for defining the role, scope and process of ambulatory oncology nursing practice, and outlines some of the practice changes that have been stimulated by nurses' greater awareness of the prevalence of these problems. Plans for continued use and tool refinement will also be discussed.