How to Evaluate the Role of a Palliative Care DNP-Prepared APRN Embedded in an Oncology Outpatient Setting

• Main Author: Hanna, Lisa
• Other Authors: Piper, Barbara F.
• Language: en
• Published: The University of Arizona. 2011
• Subjects: Nursing
• Online Access: http://hdl.handle.net/10150/203010

Studies show that palliative care APRNs are effective in mitigating patient symptoms and improving quality of life (QOL). Unfortunately, there are no theory-driven models that guide and evaluate the role of an APRN embedded in an outpatient oncology setting. Purpose. The primary purpose of this study is to evaluate the feasibility and effectiveness of a palliative care theory-driven APRN intervention using the newly developed Hanna QOL-Symptom Control Model © on the following patient-, provider-, and financial related outcomes: symptom control, QOL, patient satisfaction; time in and location of APRN follow up; provider satisfaction, number and timing of referrals; and Emergency Room visits and hospital, versus home versus hospice deaths. Methods: Design. Longitudinal, quasi-experimental pre-posttest feasibility study. Sample/Setting. All oncology patients referred to the Palliative Care APRN over one year at St. Jude Heritage Healthcare, Orange County, CA. Intervention: APRN practice translation of National Comprehensive Cancer Network (NCCN) evidence-based symptom management guidelines. Instruments. St. Jude Electronic Medical Record Demographic and Medical Record Data; Patient and Provider Satisfaction Surveys; Quality Oncology Practice Initiative Data (ASCO-QOPI); The Edmonton Symptom Assessment System (ESAS) and single item validated QOL scale, Data Analysis. Descriptive and Inferential Statistics. Limitations. Non-randomized study evaluating the role of a single Palliative Care APRN provider in one clinical setting with a primarily Caucasian sample will affect the study’s generalizability. Implications. Study results will be used to revise the intervention and Hanna QOL-Symptom Control Model© and to disseminate results to St Jude Stakeholders and others via presentations and publications. A future comparative effectiveness study is planned using these findings as baseline data.