Dados do Resumo

Título

Role of Reference Nurses in Managing the Signs and Symptoms of Systemic Treatment

Introdução

The role of reference nurses ensures the quality of care for patients and the management of signs and symptoms related to treatment. Early interventions minimize complications and ensure the proposed therapeutic plan. The reference nurse promotes quality and specialized care, playing an important role in education, leadership, monitoring patient journeys, developing and implementing guidelines and protocols, and managing health services, thus ensuring the quality of care.

Objetivo

To describe and analyze the role of reference nurses in managing the signs and symptoms of systemic treatment, the strategies used, challenges faced, and the importance of a humanized approach in clinical practice for patients enrolled in the Reference Center (CR) at a Cancer Center.

Métodos

A descriptive study in the form of an experience report conducted at AC Camargo Cancer Center, describing the work of the Reference Nurse within the Reference Center of a Cancer Center, dealing with patients undergoing systemic treatment for breast, gynecological, cutaneous, and thoracic tumors in adjuvant, neoadjuvant, and palliative settings. Data were analyzed using Microsoft Office Excel 2007 from July 2023 to July 2024. Data on signs and symptoms reported by patients were analyzed, indicating home management or visits to the Emergency Department (ED) based on telephone or in-person consultations by reference nurses, patients, and/or their support networks. Categorical variables were organized into tables and presented as absolute frequencies or simple ratios (percentages) and displayed as means with standard deviations and medians.

Resultados

During the evaluation period, 174 consultations were conducted by Reference Nurses, either by phone or in person, to manage post-chemotherapy signs and symptoms. Of these, 85 (49%) were directed to the ED, while 89 (51%) were managed remotely, avoiding the need for an ED visit. Of those referred to the ED, 65 (76%) attended, with 10 (15%) requiring hospitalization. The main signs and symptoms included: 11 (17%) fever, 11 (17%) flu-like symptoms, 8 (12%) cutaneous toxicity, 6 (9%) gastrointestinal toxicity, and 29 (45%) other toxicities. Among patients not needing an ED visit, the main signs and symptoms were: 32 (36%) gastrointestinal toxicity, 18 (20%) cutaneous toxicity, and 39 (44%) other toxicities. Interventions occurred during systemic treatment, with the first contact made after the first administration and further contacts as triggered by the patient or support network.

Conclusões

Early interventions and continuous monitoring reduce complications and hospitalizations, fostering security and trust among patients, caregivers, and the healthcare team. The role of reference nurses is crucial, positively impacting the chemotherapy process and preventing complications. However, the challenge of patients not attending the ED despite being advised highlights the need to overcome barriers and reinforce education on the importance of emergency care.

Palavras Chave

Oncology nurses; Adverse effects; chemotherapy