Congress Abstracts 2003

17

ADVANCING ONCOLOGY NURSING PRACTICE: MONTHLY COLLABORATIVE CASE STUDY PRESENTATIONS. LiChen Wann, MSN, ANP, RN, CCRN, Frances Cartwright-Alcarese, RN, PhDc, AOCN^®, Max Sung, MD, Janet Van Cleave, MSN, ACNP-CS, AOCN^®, Jane Brown, RN, BSN, OCN^®, and Rita Jakubowski, RN, ANP, MS, Mount Sinai Medical Center, New York, NY.

Expert nursing practice is associated with improved patient outcomes. To develop expert nursing, The Mount Sinai Medical Center’s Oncology Care Center Performance Improvement Committee (OCCPIC) explored methods to enhance nurses’ knowledge emphasizing evidence-based practice. The OCCPIC reviewed patient outcomes of general satisfaction surveys, chart reviews, and clinical observation. This data revealed that there is a need to include oncology-specific strategies in the patient’s plan of care. This article describes the development and implementation of a professional education project of case study presentations to the oncology interdisciplinary team (OIT) using advanced practice nurses (APN) as mentors working collaboratively with clinical nurses (CN) to enhance oncology staff knowledge. The Outcome Present State Test (OPT) Model of Reflective Clinical Reasoning (Pesut & Herman, 1999) provided the framework for this project. The major concepts in the model include the client’s story, cue logic, reflective clinical reasoning, framing, decision-making, testing, and judgment. The case presentation consists of comprehensive oncology nursing history, physical examination, pertinent diagnostic testing, interdisciplinary consultation, and nursing diagnoses concerning physical, psychological, social, spiritual, and financial aspects of caring (PPSSF). The APN and CN present two case studies monthly to the OIT using the OPT framework to stimulate discussion and develop clinical reasoning. The OIT includes all professionals in the following areas: inpatient units, bone marrow transplant program, ambulatory units, and radiation oncology. A continuing education credit is offered to all participants. Weekly meetings are held to refine and revise the program based on participant feedback. Program evaluations, increasing attendance, and overall response to the presentations suggest that the interdisciplinary oncology team is eager to learn. Ongoing monitoring of this project is conducted by the OCCPIC. To determine improvement in patient outcomes, there will be periodic reviews of the general satisfaction survey data, chart reviews, and clinical observation will be conducted.