Quality assurance issues in oncology nursing.

Oncology nursing has been given the challenge to determine if oncology patients are provided with the highest quality nursing care. Inherent in this challenge is the development of indicators to measure clinical excellence in oncology nursing practice as well as organizational excellence. The Standards of Oncology Nursing Practice by the Oncology Nursing Society (ONS) and the American Nurses' Association (ANA) provides the framework for the development of specific clinical indicators to measure oncology nursing practice. These standards contain structure, process, and outcome criteria to measure oncology nursing practice. Within these practice standards, emphasis is placed on 11 high-incidence problem areas that can occur in cancer patients at any stage of the disease process, regardless of the care setting. These problem areas should serve as the broad basis for the development of specific clinical indicators to measure the quality of nursing care provided to the oncology patient. This report provides suggestions for possible clinical indicators based on the ONS/ANA Standards and the scope of care provided by nursing to oncology patients. This report also discusses problems and issues related to quality assurance in cancer nursing, i.e., (1) the diversity of the patient populations that are cared for by oncology nurses; (2) the lack of research on clinical indicators in oncology nursing practice; and (3) the lack of a national data base on cancer nursing practice to aid in the establishment of "thresholds of acceptable performance." Possible solutions and recommendations for action are given.