INTRODUCTION:
Nursing/Allied Health (AH) practitioner- led geriatric screening and assessment service for medical oncology and malignant haematology patients aged≥60 years at three Metro North Hospital and Health Service facilities was initiated in February 2018.
OBJECTIVES:
Primary objectives of the study are to determine the feasibility and utility of nursing/AH led geriatric screening and assessment for supportive care needs and identify AH service impacts.
METHODS:
A trained nurse/AH practitioner conducted Geriatric8 (G8) screening face-to-face (F2F) or by telephone. Patients had face-to-face comprehensive geriatric assessment (CGA) if they achieved G8 score of ≤14 or clinically indicated. A bespoke CGA suite comprising 16 assessments was done by nurse/AH practitioner. Proposed care was discussed in multidisciplinary case conference and AH interventions were provided.
RESULTS and CONCLUSIONS:
533 patients underwent G8 screening from February to October 2018. 55% of patients were impaired on G8. 4% of patients with unimpaired G8 were recommended for CGA based on clinical assessment. Clinical assessment-based CGA recommendations were three times higher following F2F G8s compared to G8s by telephone. CGAs were conducted in 65% of recommended cases. Case conferences discussed 145% of patients undergoing CGA (initial presentation and follow-up). 89% (182/204) patients had at least one recommended referral. Most common impairments on CGA leading to referrals were the timed up and go (70%); mood & depression (47%) and malnutrition (45%). Our nursing/AH-based model of geriatric screening and assessment seems feasible F2F screening led to increase in clinical assessment-based recommendations for CGA. Rates of impairment on G8 were lower than indicated in literature (55% vs. 70%). Referrals for intervention following CGA were higher than indicated in literature (89% vs. 80%). Analysis is required of reasons for and outcomes of clinical assessment-based CGA recommendations. Research into quality of life and satisfaction among patients and carers is underway.