Nurse-led supportive care management: a 6-month review of the role of a nurse practitioner in a chemotherapy unit
Keith Cox A B D , Deme Karikios C , Jessica K. Roydhouse B and Kate White A BA Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
B Cancer Nursing Research Unit, Sydney Nursing School (MO2), The University of Sydney, Sydney, NSW 2006, Australia. Email: jessica.roydhouse@sydney.edu.au, kate.white@sydney.edu.au
C Concord Cancer Centre, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia.
D Corresponding author. Email: keith.cox@sswahs.nsw.gov.au
Submitted: 9 April 2013 Accepted: 4 September 2013 Published: 1 November 2013
Abstract
Objectives This case study evaluates the oncology nurse practitioner (NP) role in a chemotherapy unit.
Background The NP works in the cancer centre of a major metropolitan public hospital. The NP role was established in the chemotherapy unit in 2007. The NP reviews all patients that have an unscheduled presentation to the unit, with symptoms relating either to their disease or treatment.
Methods All unscheduled occasions of service provided by the NP in the chemotherapy unit over 6 months were recorded. Data were collected on patient demographic characteristics, medical problems and reason for presentation. Data on duration of care, interventions and outcomes administered by the NP were captured.
Results There were 87 occasions of service (72 patients) during the study period. Nausea, vomiting or dehydration were the most common presenting problems and most presenting problems were moderate or severe (n = 73, 84%). The median time to review for the NP was 5 min and nearly all consultations (n = 83, 96%) took 30 min or less. Following NP consultation, most occasions of service did not require subsequent hospital admission (n = 52, 60%), medical advice (n = 61, 70%) or medical review (n = 75, 86%).
Conclusions The NP is a valuable asset to a busy department, increasing access to timely and appropriate healthcare for patients on chemotherapy.
What is known about the topic? Models of care for oncology NP roles are being developed in Australia, but few published reports and descriptions of the work of oncology NP exist.
What does this paper add? This paper presents a description and evaluation of occasions of service for an oncology NP in a chemotherapy unit and the impact of the NP’s role on the hospital and clinical workload.
What are the implications for practitioners? This paper can inform the development of other oncology NP roles in Australian chemotherapy units, and highlights potential areas of evaluation for new NP roles in cancer care.
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