Alison Morris on Screening for Distress and Nurse-Led Algorithms

Alison Morris, RN, OCN, a Hematology/Oncology nurse practitioner at Stanford Health Care, discusses screening patients with cancer for emotional and physical distress as well as developing a nurse-led algorithm to categorize distress.

In her study, every patient in 22 different cancer care centers was screened using the Patient Reported Outcome Measurement Instrument System (PROMIS) prior to their second visit. Patients who responded as ‘fair’ or ‘poor’ to any of the nine questions on the survey were connected with a nurse who addressed the patients’ needs directly or in conjunction with the physician.

Morris says she and other researchers are in the process of developing an algorithm for nurses to follow which would categorize distress with evidence-based clinical pathways for supportive care services.

The referrals would be based on needs identified through the PROMIS tool, which identifies physical, psychosocial, emotional, and spiritual symptoms. Symptoms that are complex and multifactorial would generate a referral for palliative care, Morris says.