Development and Implementation of the Zone Tool for Oncology: A Simple Patient Teaching Tool

Publication Title

Journal of Oncology Navigation & Survivorship

Document Type

Article

Publication Date

11-2024

Abstract

Background: Oncology nurse navigators (ONNs) are key to empowering patients and caregivers with self-advocacy skills to identify and prevent treatment-related side effects. Symptom self-assessment and early intervention are key to effective symptom management and may prevent unnecessary emergency department utilization. Zone Tools have been used in several chronic diseases to facilitate rapid identification of clinical deterioration. To date, no Zone Tool has been published for use in patients with cancer.

Objectives: To describe the development and early experience of the Zone Tool for Oncology (ZT-O).

Methods: The ZT-O was developed by a 3-person oncology nurse team after attendance at the 2017 Geriatric Oncology Nursing Conference funded by a grant from the National Cancer Institute. The ZT-O is a geriatric-friendly, single-page, color-coded symptom self-assessment tool for patients undergoing anticancer treatment. It was translated for use with diverse patient populations and integrated into initial and ongoing education by ONNs, advanced practice providers (APPs), and clinical nurses at multiple sites in a single health system. The ZT-O was presented at the 2018 Geriatric Oncology Nursing Conference and was adopted by at least 2 additional sites for clinical and research use.

Findings: The ZT-O has been used by ONNs, APPs, and clinical nurses in both inpatient and outpatient settings in various geographic settings with diverse patient populations. In a pilot study of nurse/patient-family dyads, the ZT-O was feasible and acceptable to both nurses and patient/family caregivers. The ZT-O is associated with improved patient satisfaction and increased clinic visits for symptom management, possibly reducing unnecessary emergency department utilization.

Conclusion: The ZT-O is an easy-to-use summative teaching and communication tool that empowers patients/family caregivers to recognize signs of clinical deterioration. The ZT-O simplifies patient education, increases patient satisfaction, and may reduce unnecessary emergency department utilization. ONNs, APPs, and clinical nurses can customize the ZT-O for their unique patient populations to reinforce key symptom management priorities across the continuum of care.

Area of Special Interest

Cancer

Specialty/Research Institute

Nursing

Specialty/Research Institute

Oncology


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