Development of a nurse-initiated proactive telephone nursing assessment guideline for new cancer patients.

Telephone practice is an essential component of ambulatory nursing practice to address patient concerns between their clinic visits. Proactive telephone practice has been part of oncology nursing at a large regional cancer centre for six years and involves taking the initiative of calling patients and families before they are in distress. A review of nursing practice regarding proactive calls in the centre revealed a lack of standardization across cancer disease sites in identifying and assessing patients who would benefit from proactive calls, and variability in how nurses documented telephone interactions. To create a standardized approach for proactive telephone practice, we began by identifying when patients require a proactive call based on key transition points across their cancer care trajectory. Based on the practice review of proactive calls, the needs assessment with patients, and a literature review, a Proactive Telephone Nursing Assessment Guideline was developed. The guideline provided guidance for conducting a proactive telephone call and identifying patient needs, intervening as required, and documenting the exchange. The guideline was piloted with newly diagnosed patients to determine if the call helped in meeting their needs. Informational and practical needs were most common. The pilot revealed both patients and families were satisfied with the proactive call. Nurses felt the guideline was useful, but could be burdensome, especially when it was first used. Through the pilot, it was identified that proactive telephone calls can be utilized to focus on patient and family supportive care needs.