Distress assessment: practice change through guideline implementation.
Most nurses agree that incorporating evidence into practice is necessary to provide quality care, but barriers such as time, resources, and knowledge often interfere with the actual implementation of practice change. Published practice guidelines are one source to direct practice; this article focuses on the use of the National Comprehensive Cancer Network's Clinical Practice Guidelines for Oncology: Distress Management, which articulate standards and demonstrate assessment for psychosocial distress. Planning for the implementation of the guidelines in a feasibility pilot in a busy radiation oncology clinic is described. Results indicate that adding a distress assessment using the distress thermometer and problem checklist did not present substantial burden to nurses in the clinic or overwhelm the mental health, pastoral care, or oncology social work referral sources with more patients. Understanding distress scores and problems identified by patients helped the nurses direct education interventions and referrals appropriately; improved patient satisfaction scores reflected this.
Duke University Hospital, Durham, NC, USA. caryl.fulcher@duke.edu
Caryl D
CD
Fulcher
Tracy K
TK
Gosselin-Acomb
D000328:Adult; D001291:Attitude of Health Personnel; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000523:psychology; D024802:Nurse's Role; D009730:Nursing Assessment / Q000458:organization & administration*; D015403:Nursing Evaluation Research / Q000458:organization & administration*; D009859:Oncology Nursing / Q000458:organization & administration*; D009936:Organizational Innovation; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D016730:Program Development; D015397:Program Evaluation; D018787:Radiation Oncology / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000451:nursing