Impact of nurse-initiated early telephone follow-up on unplanned 30-day hospital admissions after first-cycle chemotherapy: A real-world implementation study.

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Background: Patients receiving chemotherapy may experience treatment-related side effects after discharge, particularly during the first cycle. Patients and caregivers often struggle to differentiate symptoms that can be managed at home from those requiring medical attention, leading to delayed care or unplanned hospital visits. However, structured early follow-up after chemotherapy is not routinely incorporated into post-treatment care. We implemented a nurse-initiated telephone follow-up process and evaluated its impact on unplanned hospital visits within 30 days after chemotherapy. Methods: A nurse-initiated telephone follow-up program was implemented for patients receiving their first cycle of chemotherapy in 2025. Nurses contacted patients on day 1 and day 3 after treatment to assess treatment-related symptoms, provide symptom-specific self-care advice, and screen for warning signs requiring further medical evaluation. Patients with moderate, severe, or persistent symptoms were discussed with the treating physicians. Outcomes were compared with historical pre-implementation data from 2024. The primary outcome was unplanned hospital admissions related to chemotherapy-associated side effects within 30 days. Results: In 2024, a total of 512 patients received first-cycle chemotherapy, with an unplanned 30-day hospital admission rate of 17.38% related to chemotherapy-associated side effects. In 2025, 516 patients were included following implementation of the nurse-initiated telephone follow-up program, with 9% experiencing unplanned hospital admissions within 30 days. Despite differences in patient volume between the two years, the admission rate in 2025 was lower compared with 2024. Follow-up calls in 2025 commonly addressed fatigue, gastrointestinal symptoms, and fever, and early nurse assessment facilitated appropriate escalation or nurse-led management. Conclusions: Compared with historical data from 2024, nurse-initiated telephone follow-up after first-cycle chemotherapy in 2025 was associated with a reduction in unplanned hospital admissions related to treatment-associated side effects within 30 days. This structured follow-up process supports early symptom assessment, timely guidance, and appropriate escalation of care. Integrating nurse-initiated telephone follow-up into routine oncology practice may help reduce avoidable admissions and improve supportive care delivery.