Telephone Advice and Triage within Paediatric Oncology.

The topic of telephone triage is of particular interest to the author who works in a paediatric Oncology Unit which is the principal treatment centre for children’s cancers within the Merseyside and Cheshire Cancer Network. This Unit provides 24 hour telephone advice for patients, families and carers. In addition, professionals within the network access the line for specialist information to support patients who are receiving on-going treatment for cancer, in particular, designated shared care centres and community teams who provide care nearer to home. To help develop good practice, the Oncology Unit developed a protocol supported by nine separate algorithms and a proforma upon which to document the ‘Telephone Consultation Notes’ made by the nurse (or other health professional). Having completed the handwritten documentation the policy requires the member of staff to further document these details on Meditech. The nine algorithms relate to nine separate health triggers which reflect the core of telephone triage calls and these algorithms aim to guide safe and appropriate practice and indicate what action the nurse should take. This study was developed in response to this initiative. The aim of this study was to explore triage trained nurses’ experiences of providing telephone triage in one NHS children’s oncology setting. This study was underpinned by a two phase, exploratory mixed methods design although the main focus was on the qualitative data generated in the second phase. Phase 1 involved analysis of logged telephone consultation notes. In Phase 2 selected nurses working within the setting who had received training in the triage protocol and who had logged calls within the study period were interviewed. In Phase 1, a total of 221 telephone triage calls (from parents or District General Hospitals) were logged as being received over the four months of data collection and were analysed and eight nurses (6 female and 2 male) participated in the second interview phase of the study. Following analysis of the data four main themes were identified in relation to telephone triage protocols as a means of (1) managing remote communication; (2) promoting safe and legal nursing actions; (3) ensuring best evidence-based practice; and (4) documenting comprehensive assessment Telephone triage is a relatively new development, particularly within children’s oncology care and whilst it provides parents with 24 hour access to advice and support it also creates challenges. Remote, hands-off assessment is not easy and whilst protocols can guide practice and support the practitioner to make clinical decisions it is clear that nurses in this study did not always adhere to the protocol. The study highlighted that nurses rely on their ward-based, face-to-face knowledge and skills and that this is not always readily transferable to telephone triage. Nurses expressed both levels of confidence and levels of uncertainty about their role in telephone triage. Recommendations for practice are proposed based on the findings of this study.

Name dc:type.qualificationname

msc

Level dc:type.qualificationlevel

masters

Grantor dc:publisher.institution

University of Central Lancashire

Year dc:date.issued

2014

Author dc:creator

• Rowe, Nicola Kay

Language dc:language

en