Increasing Provider Awareness and Management of Symptoms in HSCT Patients Using a Standardized Palliative Assessment: A QI EBP Project

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Increasing Provider Awareness and Management of Symptoms in HSCT Patients Using a Standardized Palliative Assessment: A QI EBP Project Abigail Barrus, DNP-S, RN, BSN; Jennifer Shaw, DNP, RN, AGPCNP-BC; Amanda Dailey-Hansen, DNP, RN, AGACNP-BC Key Take Away . Implementing standardized symptom assessment in patients with hematologic malignancy undergoing HSCT can improve provider awareness of symptom severity and overall management of patient symptoms. Background Provider Confidence 80% • About 10% or 180,000 of new cancer diagnoses in the US annually are hematologic malignancies. • Over 22,000 hematopoietic stem cell transplants (HSCTs) are performed each year in the U.S. • HSCT is a critical treatment that improves outcomes but carries heavy symptom burden. • HSCT patients have higher hospital readmission rates and longer lengths of stay due to unmanaged symptoms 73.30% 70% 60% 50% 45% 40% 30% Purpose 10% 0% • • • • • Provider pre-survey to assess baseline symptom assessment practice. Training on ESAS tool and best symptom management practice. Bi-weekly ESAS tool completion during provider assessments Tracked rates of tool utilization and screening. Provider post-survey to assess perception of ESAS tool and improved symptom assessment practice. • Provider Confidence: Increased from 45% pre-intervention to 73.3% post-intervention. • Utilization Rate: ESAS was utilized in over 65% of expected encounters. • Feasibility: Over 70% of providers completed ESAS in less than 5 minutes. • Usability: 78% of providers reported improved awareness of patient symptoms. • Satisfaction: 93% of providers supported continued ESAS use. • Identified barriers include lack of EHR integration and paper assessment use. 20% • Implement the Edmonton Symptom Assessment Scale (ESAS) to increase provider awareness and symptom management practice in patients with hematologic malignancy undergoing HSCT. Methods Results Utilization Rate 34.8 ESAS used 65.2 Pre-Intervention Post-Intervention Example of ESAS Conclusions • Standardized Symptom Assessment with ESAS improved provider awareness and confidence. • High level of provider interest supports continued use and perceived feasibility and value • Paper assessments were inconsistent showing EHR integration is essential for long-term success. • Could be adapted to other oncology and high-symptom-burden populations. • Future implications include EHR integration, automated reminders for assessment completion and clinical champion involvement for best success. ESAS not used @uofunursing @utnurseresearch