What are the perceived unmet needs for patient care, education, and research among genitourinary cancer nurses in Australia? A mixed method study.

Objective: Specialist genitourinary (GU) nurses provide care to a broad and diverse group of patients diagnosed with kidney, bladder, prostate, testicular, adrenal, and penile cancer. The purpose of this study was to identify GU cancer nurse perspectives of perceived unmet needs in service provision, specific educational and research priorities. Methods: A concurrent mixed methods study design incorporated quantitative and qualitative data collection from the GU Cancer nurses workforce in Australia. Quantitative data collected using an electronic survey instrument and were analysed using descriptive statistics. Qualitative data collected through semi-structured interviews and coded for thematic analysis. Ethical approval was gained. Results: Fifty responses were received from the electronic survey. 39/50 (78%) were female and 35 (70%) were metropolitan based. The highest domains of perceived unmet needs related to psychological/emotional needs - 17/23 (74%), intimacy needs - 15/23 (65%) and informational needs - 13/23 (57%). The themes from the qualitative interviews identified: (1) Patient needs - lack of tumour specific contact for cancer patients, fragmented delivery of cancer care, perception of better access to supportive care for public patients, lack of access to supportive care screening tools for needs assessment. (2) Educational needs - lack of GU specific cancer educational resources/learning opportunities and barriers to accessing educational opportunities. (3) Research priorities - impact on carers/partners, specific needs of different GU cancers, future focus on genetic testing/counselling, interventions for financial toxicity and development of models of care for geriatric GU patients. Conclusions: Specialist GU cancer nurses support a broad group of patients. Given the prominence of addressing unmet cancer care needs among people with GU cancers in this study, cancer nursing as a discipline alongside the multidisciplinary team, requires innovative solutions to overcome fragmented care which is often highly complex, and develop individualised and integrated care across the cancer care continuum. We encourage clinicians, researchers, policy makers, people affected by cancer, and their care networks, to continue to drive innovation by (1) Embedding an integrated approach to cancer nursing, (2) Implementation of shared care, (3) Implementation of patient navigation, (4) Embracing emerging technologies, (5) Future focus on education, and (6) Future focus on nurse-led research.

Prevention and management of urinary catheter blockages in community settings.

Self-management of long-term urinary catheters can be challenging for patients, and recurrent catheter blockages may cause concern among patients, carers and healthcare professionals. Catheter blockages are a significant challenge for nurses practising in community settings, because frequent and unplanned catheter changes can be costly to healthcare services in terms of time and resources. This article details evidence-based recommendations for the assessment and diagnosis of catheter blockages, as well as the identification of risk factors. It also explains the interventions that can be used to prevent and manage catheter blockages and describes the role of the nurse in supporting patients with a long-term catheter in situ in community settings.