Development of a Cancer Support Nurse Telehealth Clinic to facilitate symptom management and urgent clinical review

ABSTRACT

Introduction: The COVID-19 pandemic required health services to find novel approaches to provide facilitate timely review for patients receiving systemic cancer therapies (SCT). Telehealth permits greater efficiency and access and visual assessment of specific adverse effects. A pilot Telehealth Cancer Support Nurse Review Clinic (TCSN-RC) was established. This service complements existing cancer support nurse service (CSNS). The clinic is staffed by advanced practice oncology nurses, with care guided by a triage tool and an established referral pathway. Aim: To explore the use of telehealth to enhance the CSNS in providing rapid review for symptom and toxicity management of patients receiving SCT. Method: Quality improvement methodology has been used to evaluate and improve the TCSN-RC. Patient and CSN (Cancer Support Nurse) experience survey questionnaires were developed and analysed. Regular project team meetings reviewing interim results has allowed for improvement of processes. Results: Since the commencement in October 2020, there have been 18 CSN telehealth consultations. Twenty-eight per cent (n = 5) of patients and 100% (n = 4) of Cancer Support Nurses (CSN) have completed an evaluation survey. All patients (n = 5) strongly agreed or agreed they felt confident using the technology, the telehealth saved them travel time, the need to see their GP and enabled them to better manage their own symptoms. Participant reported feeling reassured by seeing a familiar face and prompt service from knowledgeable nurses. They reported having good video connections, could see and hear well. All CSN's (n = 4) strongly agreed or agreed that the telehealth consultation was convenient for them, helped to conduct better symptom assessments and were comfortable with telehealth technology Conclusion: Early results indicate the TCSN-RC service is a valuable addition to the CSN's in the delivering symptom and urgent clinical review with ongoing evaluation of results and potential for improvements in process as the study continue.