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Jun 17, 2019

MASCC/ISOO Annual Meeting on Supportive Care in Cancer

14 - 1-2-3 PROJECT: NURSE DRIVEN INITIATIVE TO NORMALIZE AND SYSTEMIZE PALLIATIVE CARE IN THE ONCOLOGY OUTPATIENT SETTING

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Abstract

• Introduction: The national consensus among leading oncology organizations is that palliative care starts at diagnosis. However, in practice, this is often not the case. Palliative care has been stigmatized and is often seen as a transition to end of life care. Nurses can play a pivotal role in breaking down stigmas and integrating primary palliative care at the onset of oncology care. • Methods: The 1-2-3 Project is a nursing clinical improvement initiative. Beginning with the first 3 visits, the patient completes brief assessments that identify symptoms, psychosocial and palliative care needs. At systematic intervals, nurses engage patients in discussions of core values and goals as it relates to their cancer care. As these discussions can stimulate strong emotions, nurses were educated to use an “acknowledge, normalize, and partner” framework. Values discussions are utilized by the clinical team as they implement care delivery. Nurses also have access to palliative care nurse practitioners to help meet the patient’s needs. • Results: Over 2 years, 211 values discussions were conducted with newly-diagnosed hematologic and GI cancer patients. Two patients declined participation. Of 43 patients surveyed, 97.7% reported feeling comfortable with the process, 97.7% considered it helpful, and 95.3% would recommend it to others. • Conclusions: With the success of this pilot, the 1-2-3 Project is now being rolled out to other clinics for further evaluation and metric collection. Additionally, a nurse supportive care champions program has been developed, another resource to help integrate primary palliative care at the onset of cancer care.

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© Copyright 2019 Morressier GmbH.
All rights reserved.