Standardizing Roles: Evaluating Oncology Nurse Navigator Clarity, Educational Preparation, and Scope of Work Within Two Healthcare Systems.

BACKGROUND: Since the introduction of patient navigation, challenges persist in standardizing the oncology nurse navigator (ONN) role, educational preparation, and scope of work. OBJECTIVES: With a goal of systemwide understanding of navigation services, two healthcare institutions examined the educational preparation, responsibilities, and understanding of the ONN role. METHODS: Two nurse leaders in navigation concurrently used surveys, focus groups, and interprofessional discussions to assess the current state of navigation within their comparable organizations. They aggregated their findings, identified commonalities, and shared standardization approaches. FINDINGS: Data demonstrated noteworthy variation in ONNs' academic preparation, professional certifications, job titles, and scope of work. Additional findings included overall lack of understanding of the role and responsibilities of ONNs, inconsistent role preparation and implementation, random tracking of methods and metrics, and insufficient job-related resources.

5-Fluorouracil and Capecitabine: Assessment and Treatment of Uncommon Early-Onset Severe Toxicities Associated With Administration.

BACKGROUND: Uncommon early-onset severe toxicities from 5-fluorouracil (5-FU) and capecitabine can be fatal if early warning signs are not recognized and treated promptly. OBJECTIVES: This article delineates the differences between expected side effects and uncommon early-onset severe toxicities from 5-FU and capecitabine. It also provides background for understanding the reasons patients may develop these toxicities and reviews the efficacy of standard supportive care against a novel therapy (uridine triacetate). METHODS: A panel of nurses convened to review the literature about toxicities associated with 5-FU and capecitabine administration and determined methods to educate nurses about toxicities and treatment. FINDINGS: Standard supportive care for 5-FU and capecitabine toxicities is associated with high fatality rates. Uridine triacetate treatment within 96 hours of administration is associated with survival.