Improving the nursing management of patients in a hematology/oncology day unit: an action research project.

This article reports on an action research project conducted in one hematology-oncology day unit in Queensland, Australia. The project consisted of three phases, each of which included observation, reflection, action, and evaluation. The first phase calculated the amount of time and the dedicated nursing hours required to administer the different chemotherapeutic protocols to patients in a number of hematology-oncology day units in Southeast Queensland. The second phase changed the patient booking and staff allocation systems following an evaluation of process and outcome measures and a patient survey. The patient survey measured both generic satisfaction and satisfaction with symptom management. The third phase introduced and evaluated the effectiveness of primary nursing and increased emphasis on patient education. The first two changes brought about by the action research process improved patient wait time, patient satisfaction, and symptom management. The changes implemented in phases 1 and 2 increased the amount of time available for nurses to engage in psychosocial care. The increased emphasis on education in phase 3 did not significantly improve patient knowledge related to self-care or appropriate health professional referral. To improve patient education, the development and implementation of a self-care education program is recommended.