Outpatient genetic risk assessment in women with breast cancer: one center's experience.

A chart audit at one cancer center, of 193 women with breast cancer, was completed to assess whether a complete family history that may indicate genetic predisposition was obtained and if that information led a provider to suggest risk reduction strategies. A risk management tool, which included a pedigree template, was used. Of the 193 charts reviewed, 88.6% had family history information recorded; 41.5% reported three generations of family history. Risk management was undocumented in 21.8% of the charts reviewed and, for those that were reported (78.2%), 7.25% were referred for genetic counseling. These results suggest that a more detailed assessment of hereditary breast cancer risk incorporating three generations of family history and additional types of cancer need to be integrated into medical oncology practice. An algorithm was developed as a guide to improve the process of evaluation and referral for genetic risk assessment.

Bridging the gap: a descriptive study of knowledge and skill needs in the first year of oncology nurse practitioner practice.

PURPOSE/OBJECTIVES: To identify the knowledge and skill needs of oncology nurse practitioners (ONPs) as they enter cancer care practice, and to identify necessary educational resources. DESIGN: Cross-sectional, descriptive. SETTING: A national e-mail survey. SAMPLE: 610 self-described ONPs from the Oncology Nursing Society's database. METHODS: The project team developed a 28-item electronic survey. The survey was randomly distributed via e-mail. MAIN RESEARCH VARIABLES: ONPs' feelings of preparedness in the first year of ONP practice. FINDINGS: In the first year of practice, 90% of ONPs rated themselves as prepared or very prepared in obtaining patient history, performing physical examination, and documenting findings. ONPs rated themselves as not at all or somewhat prepared in clinical issues of chemotherapy/biotherapy competency (n = 81, 78%), recognizing and managing oncologic emergencies, (n = 77, 70%), and recognizing and managing drug toxicities (n = 63, 61%). The primary source of oncology education for ONPs new to practice was almost exclusively the collaborating or supervising physician (n = 84, 81%). CONCLUSIONS: Specific knowledge and skills, such as information about chemotherapy, oncologic emergencies, and side effects of therapy, are needed before an ONP enters a cancer care practice. IMPLICATIONS FOR NURSING: Cancer-specific education should be made available to new ONPs as they begin independent practice.