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From reactive to proactive basic palliative hospital care. Evaluation of one-nurse-based telephone follow-up and bedside consultation to advanced gastrointestinal cancer patients and informal caregivers: A quasi-experimental study
Abstract
Rationale and aim: Organizational and staff-related barriers need to be overcome in order to integrated early palliative care and develop its supporting infrastructure. We aimed to evaluate the use of a one-nurse-staffed telephone line and bedside consultations on a surgical ward.
Method: Advanced gastrointestinal cancer patients and their relatives are offered at diagnosis telephone contact with a nurse with a specialism experience and expertise in the field of palliative care – the contact is lifelong. A proactive holistic approach is taken, including individual needs assessment, guidance, regulation of medication and a tight follow-up. The nurse also acts as a sparring advice partner for colleagues and facilitates complex situations and process. Contacts are described qualitatively in a logbook and the effect on the incidence of hospital admissions and hospital deaths was investigated using a quasi-experimental design with a historical control group. Data were processed using descriptive statistics and Chi-squared (x 2) test.
Results: Over 9 month 131 patients and 427 consultations were registred. Outgoing telephone calls to patients, caregivers and professionals (40%). Incoming phone calls (31%) and in-person meeting with patients and families during hospitalization or outpatient visits (29%). Over 15 month intervention and control period the test showed a significant reduction in the short-term admissions of < 2 days, and a significant reduction in the number of patients who died during hospitalization.
Conclusion: The telephone follow-up and bedside consultations by one qualified nurse, is an interface that supports continuity and cooperation and could underpine more effective basic palliative care.
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DOI: http://dx.doi.org/10.5750/ejpch.v4i2.1141
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