Implementation of a nurse-led visit and follow-up for patients with myeloproliferative neoplasms: a quality improvement project.
Key claim: A structured nurse-led outpatient visit with routine symptom monitoring was feasible, highly accepted by MPN patients in northern Italy, and supported engagement, self-management, and care coordination without adverse events.
Abstract
BACKGROUND: Myeloproliferative neoplasms (MPNs) are chronic haematological disorders with a significant symptom burden and implications for quality of life. Traditional physician-led outpatient models often lack sufficient time for in-depth symptom monitoring and patient engagement. This quality improvement project aimed to implement (1) a structured nurse-led visit within a haematology outpatient clinic in northern Italy, (2) routine symptom monitoring and (3) evaluation of patient-related experience. METHODS: The nurse-led visit was integrated into routine 1-day hospital activities and focused on a structured comprehensive symptom assessment, health education and self-management support. Patient-reported outcomes to assess physical, psychological, nutritional and functional aspects and patient satisfaction as patient-reported experience measures were collected using validated tools and recorded on a patient symptom diary with patients’ self-care recommendations. The Plan-Do-Study-Act cycle and the person-centred care framework guided the intervention design and iterative improvement. RESULTS: Over the first 6 months, 102 patients underwent nurse-led visits with a high adherence rate and follow-up compliance. Patients reported high satisfaction with the nurse-led visit, with a mean score of 9.6±0.75 points on a 0-10 points visual scale. The intervention optimised waiting times, promoted patient activation and strengthened nurse-physician collaboration. No adverse events occurred. CONCLUSIONS: The implementation of nurse-led visits was feasible, sustainable and highly accepted by patients. This approach aims to enhance symptom management, patient engagement and care coordination for individuals with MPNs and may prove to be a promising model for broader implementation in chronic disease management.
Why this matters
A structured nurse-led outpatient visit with routine symptom monitoring was feasible, highly accepted by MPN patients in northern Italy, and supported engagement, self-management, and care coordination without adverse events.