The Impact of COVID-19 Visitor Restrictions on Clinical Cancer Nurses.

OBJECTIVES: To explore the impact of visitor restrictions on clinical cancer nurses, their roles and duties, and the coping strategies used to address the impact. DATA SOURCES: Semistructured qualitative interviews were conducted through purposive sampling with nurses working in a clinical role within cancer services at the study site for at least 1 year. Interviews were recorded and transcribed. Textual data transcribed from interviews were analyzed for themes using NVivo version 12 software, following Braun and Clarke's six phases of thematic analysis. CONCLUSION: Visitor restrictions implemented due to COVID-19 had a significant impact on clinical cancer nurses. The study found evidence of moral injury and conflict-within the role of the nurse, the implementation of organizational policies, and nurses' professional identity and personal beliefs. Despite this adversity, nurses remained committed to their clinical practice. IMPLICATIONS FOR NURSING PRACTICE: Changes to nurses' roles and the practice environment have potentially significant impact on well-being and retention. To ensure that nurses can continue to provide high-quality nursing care in challenging environments, organizations must minimize this impact. Consistent communication and support activities, including recognizing and responding appropriately to situations, may be used in the reduction of potential moral injury and stress.

Impact of the Practice Environment on Oncology and Hematology Nurses: A Scoping Review.

BACKGROUND: Practice environments have a significant impact on nurses' practice and their retention within the oncology and hematology specialty. Understanding how specific elements of the practice environment impact nurse outcomes is important for creating supportive and safe practice environments. OBJECTIVE: To evaluate the impact of the practice environment on oncology and hematology nurses. METHODS: A scoping review was conducted according to the PRISMA-ScR Statement Guidelines. Electronic databases (MEDLINE, CINAHL, PsychINFO, Google Scholar, and Scopus) were searched using key terms. Articles were assessed according to the eligibility criteria. Data extraction was conducted with results explained through descriptive analysis. RESULTS: One thousand seventy-eight publications were screened with 32 publications meeting the inclusion criteria. The 6 elements of the practice environment (workload, leadership, collegial relations, participation, foundations, and resources) were found to significantly impact nurses' job satisfaction, psychological well-being, levels of burnout, and intention to leave. Negative practice environment elements were linked to increased levels of job dissatisfaction, higher levels of burnout, greater prevalence of psychological distress, and greater intention to leave both oncology and hematology nursing and the nursing profession. CONCLUSIONS: The practice environment has a significant impact on nurses, their job satisfaction, well-being, and intention to stay. This review will inform future research and forthcoming practice change to provide oncology and hematology nurses with practice environments that are safe and lead to positive nurse outcomes. IMPLICATIONS FOR PRACTICE: This review provides a foundation upon which to develop and implement tailored interventions that best support oncology and hematology nurses to remain in practice and provide high-quality care.

'It enables the carers to see the person first': Qualitative evaluation of point-of-care digital management system in residential aged care.

AIMS AND OBJECTIVES: To evaluate acceptability, efficiency, and quality of a new digital care management system in a residential aged care home (RACH). BACKGROUND: Improving care quality and efficiency in RACH, while simultaneously upgrading data management, is a priority for communities and governments. DESIGN: Participatory action research with mixed methods data collection was employed to evaluate a digital care management system implemented at a 169-bed RACH. This paper reports qualitative findings of the 2-year evaluation. METHODS: Qualitative data were collected using focus groups with residents, visitors, nurses, managers, care workers, and consultants; resident/visitor and staff hallway interviews and responses to open-ended questions in online staff surveys. Data were analysed thematically under the four predetermined study objectives. Reporting adhered to COREQ guidelines. RESULTS: 325 data captures from 88 participants, over seven data sources were coded. Findings indicate that the system was acceptable to both residents and staff due to perceptions of time-saving and improved quality of care. Increased efficiency was perceived through timeliness as well as reduced time spent retrieving and documenting information. Quality of care was improved through care scheduling individualised to resident needs, with reminders to avoid missed care. Relatives were reassured and activities were scheduled to loved one's preferences. The co-design implementation process was successful through commitment to quality from leadership teams and prioritising the focus on the holistic needs of the residents. CONCLUSION: A strong emphasis on co-design with care staff in developing and implementing the digital care system contributed to a system that supported nursing and care work, facilitated reporting and documentation, and improved resident care and well-being including identification of missed care. RELEVANCE TO CLINICAL PRACTICE: Nurses, carers, administrators, and advocates can support the co-design creation of information systems that suit the workflow of an organisation and keep the focus on individualised models of care provision.

Identifying the unmet supportive care needs of people affected by kidney cancer: a systematic review.

PURPOSE: To synthesize existing evidence on the unmet supportive care needs of people affected by kidney cancer, across the cancer care continuum. METHODS: A systematic review was conducted according to the PRISMA Statement Guidelines. Electronic databases (CINAHL, MEDLINE, and PsychINFO) were searched using key search terms. Articles were assessed according to pre-specified eligibility criteria. Data extraction and quality appraisal were conducted. The findings were integrated in a narrative synthesis. RESULTS: One thousand sixty-three publications were screened, and 18 publications met the inclusion criteria. The following domains of unmet needs in order of frequency included psychological/emotional needs (17/18: 94%), physical needs (10/18: 56%), social needs (4/18: 22%), interpersonal/intimacy needs (4/18: 22%), patient-clinician communication needs (3/18: 17%), family-related needs (3/18: 17%), health system/information needs (3/18: 17%), spiritual needs (3/18: 17%), daily living needs (2/18: 11%), practical needs (1/18: 6%), and cognitive needs (1/18: 6%). CONCLUSIONS: There was a wide range of unmet supportive care needs experienced by people diagnosed with kidney cancer. A prominent focus was on psychological and physical needs. Further research is needed to understand how clinical (stage/treatment) and demographic (age/socio-economic/ethnicity) variables may moderate or mediate the relationship with unmet needs over time. With many unmet needs identified, this review provides a starting place to inform future work to address the complex unmet supportive care needs of people affected by kidney cancer. IMPLICATIONS FOR CANCER SURVIVORS: Individuals living with kidney cancer have many unmet supportive care needs, and future research is needed to learn about what are the most pressing needs and how to best address these concerns to ensure holistic person-centered care is delivered.

The Role of Telehealth During the COVID-19 Pandemic Across the Interdisciplinary Cancer Team: Implications for Practice.

OBJECTIVE: This literature review aims to explore the role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer care team. DATA SOURCES: Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, and gray literature were searched using Google Scholar up until September 2020. CONCLUSION: Although the safe and effective delivery of cancer care via telehealth requires education and training for health care professionals and patients, telehealth has provided a timely solution to the barriers caused by the COVID-19 pandemic on the delivery of interdisciplinary cancer services. Globally, evidence has shown that telehealth in cancer care can leverage an innovative response during the COVID-19 pandemic but may provide a long-lasting solution to enable patients to be treated appropriately in their home environment. Telehealth reduces the travel burden on patients for consultation, affords a timely solution to discuss distressing side effects, initiate interventions, and enable possible treatment additions and/or changes. IMPLICATIONS FOR NURSING PRACTICE: Global public health disasters pose significant and unique challenges to the provision of necessary services for people affected by cancer. Oncology nurses can provide a central contribution in the delivery of telehealth through transformational leadership across all domains and settings in cancer care. Oncology nurses provide the "hub of cancer care" safely embedded in the interdisciplinary team. Telehealth provides a solution to the current global health crisis but could also benefit the future provision of services and broad reach clinical trials.