| Description |
Background: Currently, 16.9 million Americans aged 65 and older have a history of cancer, including 11.9 million cancer survivors. Bone marrow transplant (BMT) survivors experience symptoms, which encompass fatigue, sleep disturbances, neuropathy, mental health challenges, and chronic pain. Implementation of comprehensive screening processes, based on the National Comprehensive Cancer Network (NCCN) guidelines, facilitates the identification of unresolved healthcare needs in cancer survivors. Local Problem: A chart review from a quality improvement (QI) initiative at an academic cancer hospital in Utah conveyed a deficit in screening processes for BMT patients' posttreatment to identify unmet physical, emotional, and psychosocial needs. This project aimed to implement a cancer survivorship screening tool to improve the identification of unmet needs in BMT patients and increase referrals to cancer survivorship resources. Methods: A qualitative analysis of electronic health records (EHR) evaluated current screening processes to identify unmet needs of BMT patients. Thirty-two BMT inpatient nurses completed a presurvey to assess current cancer survivorship practices. After implementing the NCCN cancer survivorship screening tool, the same nurses evaluated the feasibility, usability, and satisfaction of the tool through a postsurvey. Interventions: Nurses distributed the NCCN-adapted cancer survivorship screening tool for BMT patients at inpatient discharge for six weeks (October 27, 2024-December 8, 2024). Patients who checked ‘yes' on at least one question were considered positive screens and some were referred to cancer survivorship resources. The implementation was adjusted based on weekly check-ins and feedback from BMT nurses. Adjustments included placing paper reminders at nurse stations and having charge nurses remind staff to distribute the screening tool during shift safety briefings. Results: Postimplementation of the NCCN cancer survivorship screening tool showed that out of 88 patients discharged over the 6-week implementation period, 35 patients were screened, and 19 were referred to the Wellness and Integrative Health Center based on positive screens. There were 32 positive screens, and 19 of those patients were referred. Referral limitations occurred due to issues with the complexity of orders being placed before discharge. Fifteen percent of nurses reported the screening tool significantly improved the quality of cancer survivorship care, 60% noted it moderately improved quality, and 25% revealed no change. One hundred percent of nurses indicated this tool was feasible, easy to use, and satisfactory. Conclusion: This QI project increased screening for BMT patients' unmet psychosocial, emotional, and physical needs and referrals to cancer survivorship resources. Nurses who participated in administering the screening tool found it useful, feasible, satisfactory, and easy to use. Further research to identify specific cancer survivorship resources can help with the unique needs of cancer survivors. Additionally, exploring the addition of this tool to other inpatient cancer units at the hospital can benefit all cancer survivors' care. |
