The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice. Method/Data sources An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian,

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Background: Patients with complex chronic conditions experience fragmentation of care, unnecessary hospitalization and reduced quality of life, with an increased incidence of poor health outcomes. Aim(s):The aim of this paper was to explore how nurse navigators manage client care. This was achieved through an examination of narratives provided by the nurse navigator that evaluated their scope of practice. Method(s):All nurse navigators employed by Queensland Health were invited to participate in a study evaluating the effectiveness of the service. Eighty-four selfreported vignettes were thematically analysed to understand the work from the nurses' perspectives.Results: Two themes emerged from the vignettes. Theme 1, the layers of complexity, is comprised of three sub-themes: the complex patient, the complex system and patient outcomes. Theme 2, professional attributes, has two sub-themes: personcentred care and clinical excellence.Conclusion: Navigators innovatively integrate services and address the fragmented nature of the health system. They apply expert clinical and social skills, through consistent and robust communication, to meet the needs of those with multiple chronic conditions. Implications for nursing management: Results provide insight into the new role, illuminating the work they achieve, despite system complexities. K E Y W O R D S integrated health care systems care, multiple chronic conditions, nurse navigator, nurses' role, patient navigation, quality of life | 815 BYRNE Et al.

Aim With increasing age and chronicity in populations, the need to reduce the costs of care while enhancing quality and hospital avoidance, is important. Nurse‐led co‐ordination is one such model of care that supports this approach. The aim of this research was to assess the impact that newly appointed Navigators have on service provision; social and economic impact; nurses’ professional quality of life and compassion fatigue; and analysis of the change that has occurred to models of care and service delivery. Design A concurrent mixed‐method approach was selected to address the research aims. Methods The research project was funded in July 2018 and will conclude in December 2020. Several cohorts will be studied including; patients assigned to a navigator, patients not assigned to a navigator, family members of patients assigned a navigator; and a sample sized estimated at 140 navigators. Discussion This study provides a comprehensive international longitudinal and mixed method framework for evaluating the impact of nurse navigators on quality of care outcomes for patients with chronic conditions. Impact—What problem will the study address? Even with specialty focused co‐ordinated care, patients get lost in the system, increasing the incidence of non‐compliance and exacerbation of condition. Navigators work with patients across service boundaries allowing for care that is patient responsive, and permitting variables in clinical, social and practical elements of care to be addressed in a timely manner. This novel nurse‐led approach, supports hospital avoidance and patient self‐management, while encouraging expansion and opportunity for the nursing and midwifery workforce.

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Women who are diagnosed with gynaecological cancer face a difficult journey. For women residing in areas geographically removed from major health providers the journey can be much more difficult. While they 'make do' and 'struggle on', their lived experiences can provide valuable insight into the complex issues surrounding a cancer diagnosis in rural areas. This study aimed to understand their experiences through the women's stories and sought to identify the major themes impacting on these stories. This qualitative phenomenological study undertook interviews with seven women with gynaecological cancer who reside in rural and remote north Queensland. Analysis of the data collected revealed three themes: seeking answers at a distance; sharing information within a small community; and experiences of navigating the health system. The results show the inherent difficulties in accessing support in rural areas and the difficulties associated with travelling considerable distances to undergo treatment.