Congress Abstracts 2004

9

INCORPORATING THE SPECIAL ATTRIBUTES OF AN ONCOLOGY NURSE INTO A NEW OUTREACH HOSPITAL SETTING. Gail Jens, MSN, RN, Paul Davis, MSN, RN, CNS, OCN^®, Gail Boyd, BSN, RN, Jennifer Guttman, BSN, RN, and Kelly Frazier, AND, RN, Raleigh Community Hospital, Raleigh, NC.

Duke University Hospital Cancer Center draws many oncology clients from the Raleigh area. Raleigh Community Hospital (RCH), as a part of the Duke Health Care System, was designated as the oncology outreach. The inpatient nurses verbalized little interest in oncology nursing. The physicians sensed this reluctance and were hesitant to admit their patients for treatment. However, many oncology patients were admitted to this unit for symptom management. An oncology clinical nurse specialist (CNS) was hired as a consultant to study the situation.

The purpose of this study was to identify the needs of the nursing staff, address the physicians’ concerns, and develop a plan that would promote quality care for the oncology inpatient.

A three-month retrospective review of inpatient charts looked at the number of oncology admissions, the top five DRGs, and length of stay (LOS). A one-month current review monitored patient discharge instructions, home pain control, adverse drug events, nosocomial infections, patient injury, patient satisfaction, and readmission within seven days for the same DRG. A learning needs survey was given to the unit staff. Physicians were also surveyed.

Retrospective data showed 72 oncology-related admissions, average LOS 8.5 days, and the top four diagnoses were lung, colon, breast, and prostate cancers. Current monitoring results include 35 admissions, LOS 5.7 days, chemotherapy for six patients, symptom management for 29 patients, same top cancer diagnoses, and two with unrelieved pain. The learning needs survey identified the same four top diagnoses, and the need for more information on chemotherapy administration, radiation therapy, physical assessment, quality of life, and ethical issues. The physician survey is pending. During this time, a full-time oncology CNS was hired!

Our plan includes a three-day oncology curriculum with the full-time staff completing it by February 2004. OCN^® certification is recognized in the clinical ladder and present staff are to take it within two years. Additional resources for staff and patients will be provided. Ongoing monitoring of patient satisfaction, number of admissions, and staff retention will be conducted. Oncology patients deserve quality care from nurses with knowledge of their special needs. Our goal is to give this quality care.