Congress Abstracts 2006

32

ALIGNING NURSING RESOURCES WITH PATIENT NEEDS: AMBULATORY NURSE-LED CANCER CARE IN BRITISH COLUMBIA. Tracy Truant, RN, MSN, and Elena Serrano, RN, BSN, MLT, British Columbia Cancer Agency, Vancouver, Canada.

Challenged with finding new ways to safely and efficiently prioritize and meet escalating patient need, against a backdrop of fiscal restraint, nurses in one provincial cancer agency designed and are implementing a new ambulatory model of care that is patient needs focused and outcome-oriented. Ambulatory nurse-led Patient Support Clinics (PSCs) provide patients with timely access to nursing care that meets expressed needs (e.g. symptom management; education, treatment decision making support and counseling; referral to resources; navigation of cancer care system, etc). Patient Support Clinics are facilitated by Registered Nurses practicing to their full scope, supported by the interprofessional team, and complement the existing medically oriented clinics.

The purpose of this project is to align patient needs with nursing resources in the ambulatory care setting to achieve specific outcomes for patients, nurses, and the interdisciplinary team. Current practice did not align nursing resources with patient needs, nor specifically measured outcomes of nursing care, leading to concerns about gaps in care and suboptimal clinical outcomes for patients.

Focus groups, literature review, site visits and pilot studies provided the foundation for nurses to examine and gain clarity regarding their role, scope of practice, and identification of population-focused patient needs for nursing care. Competencies to practice to full scope as RN in nurse-led PSCs were articulated, and ongoing education is in progress. A rigorous evaluation plan was articulated with outcomes measured at baseline, three months and one-year post implementation. Change theory and transition models are being utilized throughout the change process to guide and reflect on the evolution of this new care delivery model.

Preliminary results indicate that nurse led PSCs are a feasible option to deliver care that is patient needs focused and supports nurses to practice to their full scope. Patients report receiving timely access to nursing care, optimal symptom control, and improved quality of life when cared for within a PSC. Nurses have reported greater job satisfaction, and an improved quality practice environment.

It is anticipated that nurse-led PSCs will enhance nursing recruitment and retention, enhance the image of nursing in cancer care, and improve interprofessional collaboration.