CHAPEL HILL, NC — When cancer patients experience medical problems, they may visit emergency departments, but how often and for what reasons, there is little data.
A first-ever study of emergency room use by oncology patients in North Carolina was published in the May 23, 2011 online issue of the Journal of Clinical Oncology. Authors hope the study can give them information so that they can target clinical problems to improve delivery of quality cancer care, thus avoiding emergency room visits.
Deborah Mayer, PhD, RN, AOCN, FAAN, associate professor of nursing in the UNC School of Nursing, study lead author, said, “While some cancer patients develop acute problems that do require a visit to the emergency department, some visits might be avoided with better symptom management.” Mayer is a member of UNC Lineberger Comprehensive Cancer Center.
The UNC team used a statewide database to collect information on over 35,000 Emergency department (ED) visits. They learned that the top three problems that brought patients to the ED were related to pain, respiratory distress, and gastrointestinal issues (mostly nausea and vomiting).
Mayer thinks some of these problems, such as nausea and vomiting, could be managed by the patient and cancer doctors and nurses. Reasons for a problem need to be explored: did the patient not get a prescription? Was the patient able to fill the prescription and take the medication? If it wasn’t working, did they call their doctor or nurse? Mayer concludes by saying that ‘While we have made great strides in cancer care, this study shows we still have room for improvement’.
Unlike other people visiting the emergency department where about 15 percent were admitted to the hospital, over 63 percent of cancer patients were admitted.
Debbie Travers, PhD, RN, CEN, FAEN, assistant professor in the UNC School of Nursing and study co-author, believes that “the Study validates the need for emergency department nurses to play an active role in the care and management of acute problems faced by cancer patients.” She said that the study identified additional areas for research, including management of acute symptoms for targeted populations, especially patients with lung cancer.
Other UNC authors are: Annah Wyss, MPH of the UNC Gillings School of Global Public Health; Ashley Leake, RN-BC, MSN, OCN, UNC School of Nursing; and Anna Waller, ScD, UNC School of Medicine. This research was funded by the NC TraCS Institute at UNC-Chapel Hill, one of 55 medical research institutions working together as a national consortium to improve the way biomedical research is conducted across the country. The consortium is funded through the NIH Clinical and Translational Science Awards (CTSA)
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