Dawn Stacey1, Meg Carley2, Barbara Ballantyne3, Myriam Skrutkowski4, Angela Whynot5. 1. School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada; Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada. Electronic address: dstacey@uottawa.ca. 2. Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada. Electronic address: meg.carley@queensu.ca. 3. Northeast Cancer Center, Health Sciences North, 41 Ramsey Lake Road, Sudbury, ON P3E 5J1, Canada. Electronic address: bballantyne@hsnsudbury.ca. 4. Cancer Care Mission, McGill University Health Centre Research Institute, Montreal General Hospital, 1650 Cedar Avenue, Montreal, QC H3G 1A4, Canada. Electronic address: mskathome@gmail.com. 5. Capital Health, 1276 South Park Street, Victoria Building, Halifax, NS B3H 2Y9, Canada. Electronic address: angela.whynot@cdha.nshealth.ca.
Abstract
PURPOSE: To assess factors perceived to influence nurses' use of symptom protocols when providing remote management for oncology patients. METHOD: A mixed methods descriptive study was guided by the Knowledge-to-Action Framework. In 2013, 8 focus groups and 7 interviews were conducted with 49 nurses or patients/family members in three ambulatory oncology programs within different provincial healthcare systems. Role-play with a protocol was used during nurse focus groups/interviews. Nurses who provided remote symptom support received a survey. Data was triangulated using thematic analysis guided by the Ottawa Model of Research Use. RESULTS: Over 90% of nurses provide telephone support during regular hours only. These symptom protocols were being used by 14% of nurses at one program. Nurses rated the protocols positively for content and format (>85%) but 20% indicated too complex. Protocol facilitators were systematic approach, comprehensive, and evidence-based. Protocol barriers were too long, not for symptom clusters, and inadequate space for documenting. To facilitate use, nurses need to enhance their knowledge (73%) and skills (58%), get access to resources, and obtain performance feedback. Nurse barriers included the learning curve, being unaware of protocols, and feeling tied to a script. Organizational barriers were communication challenges with patients, lack of electronic charting, and no clear direction to use them (54%). CONCLUSIONS: Several barriers and facilitators were perceived to influence the use of symptom protocols. Nurses and patients/family members identified similar factors. Interventions are needed to overcome barriers to nurses using the protocols such as education, clear organizational mandate, and integration with documentation.
PURPOSE: To assess factors perceived to influence nurses' use of symptom protocols when providing remote management for oncology patients. METHOD: A mixed methods descriptive study was guided by the Knowledge-to-Action Framework. In 2013, 8 focus groups and 7 interviews were conducted with 49 nurses or patients/family members in three ambulatory oncology programs within different provincial healthcare systems. Role-play with a protocol was used during nurse focus groups/interviews. Nurses who provided remote symptom support received a survey. Data was triangulated using thematic analysis guided by the Ottawa Model of Research Use. RESULTS: Over 90% of nurses provide telephone support during regular hours only. These symptom protocols were being used by 14% of nurses at one program. Nurses rated the protocols positively for content and format (>85%) but 20% indicated too complex. Protocol facilitators were systematic approach, comprehensive, and evidence-based. Protocol barriers were too long, not for symptom clusters, and inadequate space for documenting. To facilitate use, nurses need to enhance their knowledge (73%) and skills (58%), get access to resources, and obtain performance feedback. Nurse barriers included the learning curve, being unaware of protocols, and feeling tied to a script. Organizational barriers were communication challenges with patients, lack of electronic charting, and no clear direction to use them (54%). CONCLUSIONS: Several barriers and facilitators were perceived to influence the use of symptom protocols. Nurses and patients/family members identified similar factors. Interventions are needed to overcome barriers to nurses using the protocols such as education, clear organizational mandate, and integration with documentation.
Authors: Dawn Stacey; Esther Green; Barbara Ballantyne; Myriam Skrutkowski; Angela Whynot; Lucie Tardif; Joy Tarasuk; Meg Carley Journal: Support Care Cancer Date: 2015-08-15 Impact factor: 3.603
Authors: C Ludwig; J Renaud; L Barbera; M Carley; C Henry; L Jolicoeur; C Kuziemsky; A Patry; D Stacey Journal: Curr Oncol Date: 2019-02-01 Impact factor: 3.677
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Authors: Matthew B Mackwood; Tor D Tosteson; Jennifer A Alford-Teaster; Kevin M Curtis; Mary L Lowry; Jennifer A Snide; Wenyan Zhao; Anna N A Tosteson Journal: JCO Oncol Pract Date: 2022-04-21
Authors: C Vila; C Reñones; T Ferro; Mª Á Peñuelas; M Del Mar Jiménez; Á Rodríguez-Lescure; M Muñoz; R Colomer Journal: Clin Transl Oncol Date: 2016-08-03 Impact factor: 3.405
Authors: Matthew Mackwood; Rebecca Butcher; Danielle Vaclavik; Jennifer A Alford-Teaster; Kevin M Curtis; Mary Lowry; Tor D Tosteson; Wenyan Zhao; Anna N A Tosteson Journal: JMIR Cancer Date: 2022-08-16
Authors: Dawn Stacey; Esther Green; Barbara Ballantyne; Joy Tarasuk; Myriam Skrutkowski; Meg Carley; Kim Chapman; Craig Kuziemsky; Erin Kolari; Brenda Sabo; Andréanne Saucier; Tara Shaw; Lucie Tardif; Tracy Truant; Greta G Cummings; Doris Howell Journal: Worldviews Evid Based Nurs Date: 2016-05-31 Impact factor: 2.931