Poster Presentation Cancer Survivorship 2019

The role of generalist community nurses in survivorship cancer care (#251)

Kate KW White 1 2 , Heather HM McKenzie 1 , Lillian LH Hayes 1 , Judith JF Fethney 1 , Janette JV Vardy 3 , Jodi JM McLeod 4 , Natalie NC Cook 5 , Lisa LH Horvath 6 , Simon SW Willcock 7 , Chantale CB Boustany 1 2 , Bora BK Kim 1 2 , Louise LA Acret 1 2 , Gemma GC Collett 1 2 , Judy JS Simpson 8
  1. School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia
  2. Cancer Care Research Unit, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  3. Medicine, Concord Clinical School, University of Sydney, Concord, NSW, Australia
  4. Sydney District Nursing, Sydney Local Health District , Sydney, NSW, Australia
  5. NSW/ACT Primary Health Network , Australian Government Initiative, Leonards, NSW, Australia
  6. Chris O'Brien Lifehouse, Medical Oncology, Camperdown, NSW, Australia
  7. Health Sciences Centre, Macquarie University, Macquarie Park, NSW, Australia
  8. School of Public Health, Sydney University, Camperdown, NSW, Australia

BACKGROUND:

Equipping the health care workforce with skills to manage the needs of the growing number of cancer survivors is a challenge. Generalist/district community nursing services are an existing resource well placed to provide in-home cancer care.

METHODS:

In collaboration with the Cancer Institute, NSW, we developed a web-based education program designed to support generalist community/district nurses providing home-based care for chemotherapy outpatients. Nurses completed a questionnaire before and after the education program, rating their confidence in managing chemotherapy-related side effects, identifying need for referral to, and liaison with the cancer centre/hospital, and knowledge of where to access reliable treatment information. Interviews were conducted with 7 nurses who had completed the education and subsequently provided targeted, supportive care to patients following treatment. Interviews were designed to gain insight into participant perceptions of (i) their confidence to provide this care, and (ii) the feasibility of community nursing services caring for chemotherapy outpatients. This is a mixed method study using a paired sample t-test and qualitative interviews. 

RESULTS:

Overall 133 community nurses were recruited and 65 nurses completed the survey. There was a significant improvement in mean confidence across all items from pre (3.24, SD 0.72) to post education (4.11, SD 0.42, P <0.001). Nurses interviewed saw the benefit of providing targeted support to chemotherapy patients at home, and highly valued the education. They indicated the education equipped them to confidently care for this patient cohort, and that providing this service was within their scope of practice. 

CONCLUSION:

The evaluation of this education program demonstrates the feasibility of extending the scope of practice of generalist nurses to provide cancer care in the primary setting. Potential exists for this model to be adapted to equip generalist community nurses with skills and confidence to provide quality survivorship cancer care.