Director of Pediatric Nursing UF Health Proton Therapy Institute Jacksonville, Florida, United States
Title: Improving Follow-Up Rates in Pediatric Radiation Oncology: A Quality Improvement Project
Abstract :
Background: Radiation therapy (RT) can cause late effects that do not manifest for months to years following the completion of treatment. Increased survival rates place childhood cancer survivors treated with radiotherapy at increased risk for long-term effects. Follow-up care and survivorship are vital to the early detection and treatment of late effects of RT. Problem: The lack of follow-up among cancer survivors can result in considerable physical and psychosocial sequelae that can be mitigated with early detection. The absence of a formal follow-up program negatively impacted follow-up rates among childhood cancer survivors at an outpatient RT facility. Purpose/
Objective: This quality improvement project aimed to improve the follow-up rates in an outpatient RT facility through the development and implementation of an evidence-based assessment form and nurse-led outreach program created using COG survivorship guidelines and recommendations.
Methods: This evidence-based quality improvement project compared pediatric patients' pre- and post-follow-up rates after implementing a nurse-led follow-up and outreach program. Nurses attended an educational session regarding RT late effects and the nurse's role in survivorship and introduced a follow-up assessment form. Pre- and post-education surveys were completed to assess effectiveness.
Results: Baseline scores from the survey revealed nurse knowledge of the late effects of RT and confidence in providing survivorship care improved from 4.0 to 4.4. Implementing a nurse-led follow-up and outreach program increased the number of childhood cancer survivors engaged in follow-up care from 50.3% to 59.2% over eight weeks.
Conclusions: Nurses are well-educated and equipped to provide follow-up care to patients. Nurse-led clinics can provide care that meets patients' and families' physical, spiritual, and socio-cultural needs while alleviating communication, cultural, financial, and physical barriers to care.
