Nurses Use Innovation to Perform Symptom and Pain Assessments
Symptom and pain assessment tools can measure (https://doi.org/10.1016/j.pmn.2020.03.007) multiple aspects of a patient’s pain experience in both ambulatory and acute care settings. My interest in symptom assessment began with to my work as an oncology nurse practitioner, when I witnessed how symptom management can make a positive difference in patients’ lives and ability to tolerate cancer treatment.
At New York University (NYU) Rory Meyers College of Nursing, we created the NYU Electronic Patient Visit Assessment (ePVA), a patient-reported symptom monitoring clinical support tool for patients with head and neck cancer. Patients complete the assessment electronically, and that data are immediately stored on cloud platforms. Then, reports automate to clinicians for real-time interventions, providing (https://doi.org/10.21037/mhealth-19-250) a global picture of a patient’s status as part of their visit.
ePVA consists of 21 categories of binomial (yes or no) questions about common head and neck cancer symptoms. Some questions are conditional and follow branching logic to tailor the assessment to a patient’s current health status and limit respondent burden. For example, one question asks if the patient has experienced pain in the past seven days. If the patient answers “yes,” ePVA directs them to complete a multidimensional pain assessment. But if the patient answers “no,” ePVA directs them to complete questions about a different symptom.
I am conducting a pilot randomized clinical trial (http://clinicaltrials.gov/ct2/show/NCT04502797) to evaluate the effect of ePVA on pain and quality of life for patients with head and neck cancer. Our current work builds on our prior clinical usefulness studies of ePVA that found that the system is a reliable, valid clinical support tool. In fact, oncology providers (https://doi.org/10.21037/mhealth.2019.06.05) tell us that ePVA reports provide actionable information that helps them target interventions to patients’ needs, and 90% of patients agreed that ePVA is easy to use.
In 2021, my team received a National Science Foundation award to support our participation in the National I-Corp’s program, an experiential education program on integrating scientific inquiry with industrial discovery to move innovations toward commercialization to benefit the public good. The experience helped us learn how to use successes and failures to move forward with innovation, and we applied our knowledge to quickly adapt ePVA’s technology for remote symptom monitoring during the COVID-19 pandemic.
The pandemic reinforced that nurses are leaders, innovators, and scientists. Nurses are at the forefront in uncovering methods and processes that ensure equal access to symptom assessment and management, regardless of race, ethnicity, zip code, and digital literacy. Future nursing research should evaluate the implementation of symptom assessment and management in real-world settings and identify the mechanisms that make symptom assessments a powerful tool in clinical care.
Our work with ePVA builds on the research of expert nurses who paved the path in symptom assessment and management and couldn’t be possible without the NYU Langone Head and Neck Cancer interprofessional team, funders, and patients who volunteered for our studies.