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    Implementation of NCCN Distress Management Guidelines by Member Institutions

Implementation of NCCN Distress Management Guidelines by Member Institutions

Implementation of NCCN Distress Management Guidelines by Member Institutions
Abstract
Up to half of all adults with cancer experience clinically significant psychological distress and much of this distress goes unrecognized and untreated. As part of an effort to improve the care of cancer patients, the National Comprehensive Cancer Network (NCCN) has developed clinical practice guidelines for distress management that include recommendations about the evaluation and treatment of distress. These authors conducted a study to evaluate the implementation of these distress management guidelines by NCCN member institutions. The NCCN member institutions that treat adults were asked in April and May 2005 to describe their distress management practices, and 15 (83%) provided responses. Of these, 8 (53%) conduct routine distress screening for at least some patient groups, with 4 additional institutions (27%) pilot-testing screening strategies. However, only 20% of surveyed member institutions screened all patients as the guidelines recommend. In addition, whether institutions that conduct routine distress screening do so through standardized assessment methods is unclear, because 37.5% of institutions that conduct screening rely only on interviews to identify distressed patients. Findings suggest that most institutions consider screening patients’ mental health concerns important and worthwhile, but that greater implementation of guideline recommendations is needed.

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    Distress Assessment: Practice Change Through Guideline Implementation

Distress Assessment: Practice Change Through Guideline Implementation

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.

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FSOSW Board Meeting April 8 2016

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