Effects of a Telephone Nurse-Led Care Path for Pain Management in Head and Neck Cancer Patients Receiving Radiation Therapy

Abstract

Head and neck cancer patients receiving radiation therapy can have debilitating pain. The pain can impact the patient’s activities of daily living. Due to this discomfort patients have a difficult time eating, drinking, talking, breathing, and swallowing their own saliva. This inability to eat or drink, stay hydrated, or consume the nutrients the body needs to thrive results in dehydration, emergency department visits, and admissions into the hospital. The head and neck cancer patient answered a six-question survey with each phone call to address pain medication and pain level. The purpose of this quality improvement project was to incorporate and analyze a nurse-led telephone care path. This care path required the nurse to call a head and neck cancer patient receiving radiation therapy 48-72 hours after being prescribed pain medication from a radiation oncologist. Nineteen patients were treated from December 10, 2021, to May 31, 2022. During their initial on-treatment visit, the mean pain level was 2.25, while the mean pain level at the end of treatment was 6.25. From December 10, 2021, to May 31, 2022, a total of five patients out of 19 (26%) were admitted. Three patients were admitted from their emergency department visit and two patients (10%) were directly admitted by their medical oncologist. Care must be used when treating head and neck cancer patients. Additional care and interventions are needed to help treat pain in head and neck cancer patients to decrease hospital admissions and visits to the emergency department.