Bridging the Gap: Standardizing Inpatient/Outpatient, Adult/Pediatric Oncology Nursing Practices in a Rural Health Care Setting

Nurse Training

To assist with knowledge acquisition, the group developed scenario-based, hands-on skills stations. The skills stations included chemotherapy administration set-up with IV tubing, extravasation management of vesicants and irritants via peripheral and central venous access devices, clean-up of hazardous drug spills, handling body fluids and contaminated linen of patients receiving hazardous drugs, and management of a patient experiencing a hypersensitivity reaction. The event was held in the hospital’s simulation lab over multiple days throughout the week, including during day and night shifts, to allow all staff an opportunity to attend. Oncology nursing staff from all areas volunteered to lead stations through a train-the-trainer approach.

Staff feedback from the event was extremely positive, and many participants commented that it was long overdue and were excited to meet the staff “from the other side.” In the evaluation tool, many participants reported feeling more competent and confident in caring for patients undergoing treatment. In addition, they were thankful that equipment, processes, and policies were similar in all areas. After the event, the management team often found staff were networking more often with the different oncology areas when caring for a patient receiving chemotherapy.

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Finishing Touches

Next steps for the team includes standardizing education resources provided to patients and families; during the skills event, this was another area for which nursing staff identified a lack of consistency. The group is also developing an intranet site to serve as a clearing house for just-in-time education and job aids for all oncology nursing staff.

Oncology nurses practicing in rural settings lack resources, time, and opportunities to standardize and update evidence-based practices. Frontline nursing staff have the ability to make major contributions to their practice and might consider taking the lead in creating a similar project to bridge gaps between inpatient and outpatient oncology departments. This project is easily adaptable in any organization and can significantly improve continuity of care.

Reference

Neuss MN, Gilmore TR, Belderson, KM, et al. 2016 updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, including standards for pediatric oncology. Oncol Nurs Forum. 2017;44(1);31-43.