RESUMO
To plan for a proactive approach to support patients traveling for their treatment during the COVID-19 pandemic, a network of oncology hospitals worked within existing collaborative agreements to define policies and procedures to transition care for patients living in communities in close proximity to a member institution. Nurse leaders were instrumental in collaborating with and leading interprofessional partners to achieve these outcomes. These efforts led to patients' abilities to continue treatment in their local community, ensuring continuity of cancer care.
Assuntos
Infecções por Coronavirus/epidemiologia , Atenção à Saúde/organização & administração , Neoplasias/terapia , Pandemias , Pneumonia Viral/epidemiologia , COVID-19 , Continuidade da Assistência ao Paciente/organização & administração , Comportamento Cooperativo , Prática Clínica Baseada em Evidências , Humanos , Enfermagem OncológicaRESUMO
This quality improvement project evaluated the accuracy of harm scores entered into an event reporting system by inpatient nursing staff at a National Cancer Institute-designated comprehensive cancer center. Nurses scored 10 safety scenarios using 2 versions of the Agency for Healthcare Research and Quality scale to determine interrater reliability. Results indicated inconsistency in the way nurses scored the scenarios, suggesting that the event reporting system may not accurately portray the severity of harm in patient safety events. Nurse executives can use this information to guide the development and implementation of incident reporting systems.
Assuntos
Redução do Dano , Erros Médicos/prevenção & controle , Segurança do Paciente , Melhoria de Qualidade , Adolescente , Adulto , Feminino , Humanos , Liderança , Masculino , Erros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias/terapia , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Cancer is the leading cause of nonaccidental morbidity and mortality among young adults (YAs) in the United States. Stem cell transplantation (SCT), a treatment modality for a variety of YA malignancies, often requires prolonged hospitalization and immune-compromising treatment regimens. Stem cell transplantation may isolate YAs physically and emotionally, contributing to uncertainty about treatment processes, outcomes, and long-term sequelae. Studies in this population suggest that uncertainty can contribute to difficulty accomplishing basic developmental tasks. Few studies have examined the experiences of YAs in active cancer treatment, particularly those undergoing SCT. OBJECTIVES: This study explored the cancer experiences of YAs aged 18 to 25 years leading up to SCT and explored how YAs construct issues of uncertainty related to the transplantation experience. METHODS: Interviews with 14 YAs conducted within 24 hours of admission to undergo SCT were analyzed using thematic analysis from a medical ethnographic perspective. RESULTS: Themes emerged within 2 domains: relational and psychoemotional. The relational theme of "altered relationships" included the subthemes of "moving from" and "moving toward." The psychoemotional theme of the "power of perspective" included the subthemes of "optimism," "acknowledgment of death," "informational empowerment," and "developing a new outlook." CONCLUSIONS: Our findings offer new insights into the YA experience in the context of active cancer treatment, specifically how the cancer experience impacts relationships and how this experience is influenced by YAs' perspectives. IMPLICATIONS FOR PRACTICE: This study provides a foundation for addressing the psychosocial needs of YAs hospitalized for SCT, paying particular attention to the development of specific interventions.
Assuntos
Neoplasias/mortalidade , Neoplasias/psicologia , Transplante de Células-Tronco/psicologia , Sobreviventes/psicologia , Adolescente , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Neoplasias/complicações , Pesquisa Qualitativa , Estados Unidos , Adulto JovemRESUMO
A delay in hepatic artery infusion catheter removal may prolong patient discomfort and lead to additional complications. As a result, this article evaluated the effectiveness of shifting the responsibility of catheter removal from advanced practice or medical staff to nurses. Overall, patients were satisfied, felt comfortable, and experienced minimal pain irrespective of whether their catheter was removed by a nurse, physician, or advanced practice staff. Nurses also were satisfied and felt they had enhanced their ability to provide quality patient care.