Submit Manuscript | http://medcraveonline.com Research QuestionTo gain further insight into the processes that ONP navigators use in cancer care, a qualitative descriptive study was undertaken to answer the following research question: What processes do ONP navigators use in caring for cancer patients? Philosophical OrientationConstructivism was the philosophical orientation for the study. Data and analyses are created from shared experiences and relationships with participants and other sources of data [7]. Methods Procedure for collection and treatment of dataGrounded theory was chosen as the methodology. It has defined guidelines that link theory with practical application resulting in theoretical explanation [8]. SettingThe settings for the study included telephone interviews in a location convenient to the participant in any area of the United States. For the most part, the researcher conducted the telephone interviews from her private study behind closed doors located in her place of residence in Houston, Texas. ParticipantsThe study participants were recruited from all areas of the United States. To be eligible for the study, the nurse practitioners were required to be working as navigators and meet the following criteria: 1) license to practice as an NP in their respective state; 2) certification to practice as an oncology nurse; 3) minimum of 5 years full time experience in oncology nursing; and 4) English speaking. AbstractEvolving research has shown that oncology nurse practitioner navigators (ONPNs) improve clinical outcomes [1][2][3][4]. Models for quality assurance such as the Donabedian [5] model have stressed the critical linkage between the role that processes have in determining outcomes, and the challenges involved in determining cause and effects of these components. According to the Donabedian [5] construct of structure, process, and outcome, each organizational factor is influenced by the previous. A study was undertaken [6] to better define the process that ONPNs use in caring for cancer patients which answered the question what processes do ONP navigators use in caring for cancer patient? A major finding of this study was that program development was evident in all phases of the navigation, and evolved to incorporate a navigation system. The navigation system involved a placement of navigators in key positions that would facilitate timely care. The thrust to deliver high quality timely cancer supports the current trend in health care which is the moving away from fee for service to bundled payment reimbursement. The trend towards capitated and bundled payments results in payment for blocks of care; thus laying the financial responsibility on the care delivery system to assume care for the specified time period. The Oncology Care Model (OCM) is a new healthcare delivery model that was designed to provide cost effective quality care for chemotherapy patients. Services center upon the provision of services emphasizing care coordination, navigation, and national benchmark treatment guideline...
Seven studies met the criteria for this review. Research is emerging that shows benefit in using an oncology nurse practitioner navigator for ensuring timely care and patient and staff satisfaction. These metrics are in line with expert consensus recommendations. The need for more research identifying sound research tools that have been rigorously tested has been identified.
Oncology nurse practitioner (ONP) patient navigators may improve clinical outcomes. However, no standard measures of the process of oncology patient navigation or of related clinical outcomes exist, and research in this area is limited. The exploratory pilot study detailed in this article used grounded theory and interviews with three ONPs to define the processes employed by ONP patient navigators in caring for patients with cancer. .
The American Dietetic Association Nutrition Care Process (NCP) is designed to improve patient care and interdisciplinary communication through the consistent use of standardized nutrition language. Supported by Dietitians of Canada, the NCP has been gaining prominence across Canada. In spring 2009, registered dietitians at Providence Health Care, an academic, multisite health care organization in Vancouver, British Columbia, began using the NCP with a focus on nutrition diagnosis. The success of nutrition diagnosis at Providence Health Care has depended on support from the Clinical Nutrition Department leadership, commitment from the NCP champions, regularly scheduled lunch-and-learn sessions, revised nutrition assessment forms with a section for nutrition diagnosis statements, and the Pocket Guide for International Dietetics & Nutrition Terminology (IDNT) Reference Manual. Audit results from June through August 2010 showed a 92% nutrition diagnosis completion rate for acute-care and long-term care sites within Providence Health Care. Ongoing audits will be used to evaluate the accuracy and quality of nutrition diagnosis statements. This evaluation will allow Providence Health Care dietitians to move forward with nutrition intervention.
Alterations in taste can occur as a result of cancer, cancer treatment, and from a variety of other causes. Cancer patients frequently experience taste alterations, which often go undetected in the clinical setting. This case presentation depicts a 90-year-old client with end-stage pancreatic cancer undergoing chemotherapy treatment with gemcitabine. The symptomatology of taste changes is described. Etiology and rationale for taste changes is presented for the cancer patient population, and for the general population. Review of the cancer literature, research instruments, and goals/outcomes are discussed. The author determined that interventional studies are lacking, and research is needed.
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