Adaptation of the Nursing Activities Score for oncologic care.

OBJECTIVE: To adapt the contents of the Nursing Activities Score (NAS) tool to assist patients with cancer. METHOD: Methodological research that according to the Delphi Technique is a method aiming at the validation of content through agreement of experts. RESULTS: It took two rounds of opinion of experts, which added content contributions without modifying the structure and score of the original tool. The level of agreement ranged from 71 to 86%, and biological factors and assistance were more suggested: Monitoring and controls; Laboratory investigations; Support and care for family members and patients; Intravenous replacement; Renal support; Management activities. CONCLUSION: A high level of complexity of patients with cancer, and the demand for care and biopsychosocial-spiritual care was diagnosed. This tool will enable the measurement of the workload of the Oncology Nursing team, which can contribute to the staffing dimensioning.

Adaptation of the Nursing Activities Score for oncologic care / Adaptación del Nursing Activities Score para la asistencia oncológica / Adaptação do Nursing Activities Score para assistência oncológica

ABSTRACT Objective: To adapt the contents of the Nursing Activities Score (NAS) tool to assist patients with cancer. Method: Methodological research that according to the Delphi Technique is a method aiming at the validation of content through agreement of experts. Results: It took two rounds of opinion of experts, which added content contributions without modifying the structure and score of the original tool. The level of agreement ranged from 71 to 86%, and biological factors and assistance were more suggested: Monitoring and controls; Laboratory investigations; Support and care for family members and patients; Intravenous replacement; Renal support; Management activities. Conclusion: A high level of complexity of patients with cancer, and the demand for care and biopsychosocial-spiritual care was diagnosed. This tool will enable the measurement of the workload of the Oncology Nursing team, which can contribute to the staffing dimensioning.

RESUMEN Objetivo: Adaptar el contenido del instrumento Nursing Activities Score (NAS) para la asistencia de pacientes oncológicos. Método: Investigación metodológica que, de acuerdo con la Técnica Delphi, se trata de un método que pretende validar contenido por medio de un consenso de expertos. Resultados: Fueron necesarias dos rondas de opinión de expertos, que añadieron contribuciones de contenido sin modificar la estructura y la puntuación del instrumento original. El nivel de concordancia varió de 71% a 86%, siendo que los factores biológicos y asistenciales sufrieron más sugerencias: Monitoreo y controles; Investigaciones de laboratorio; Apoyo y cuidados a los familiares y pacientes; Reposición intravenosa; Soporte renal; Actividades gerenciales Conclusión: Se diagnosticó un alto nivel de complejidad del paciente oncológico, además de la demanda de cuidados asistenciales y biopsicosociales espirituales. Este instrumento posibilitará la medición de la carga de trabajo del equipo de Enfermería en Oncología, lo que puede contribuir al dimensionamiento del personal.

RESUMO Objetivo: Adaptar o conteúdo do instrumento Nursing Activities Score (NAS) para assistência de pacientes oncológicos. Método: Pesquisa metodológica que, de acordo com a Técnica Delphi, trata-se de um método que visa validar conteúdo por meio de um consenso de experts. Resultados: Foram necessárias duas rodadas de opinião de especialistas, os quais acrescentaram contribuições de conteúdo sem modificar a estrutura e a pontuação do instrumento original. O nível de concordância variou de 71 a 86%, sendo que os fatores biológicos e assistencias sofreram mais sugestões: Monitorização e controles; Investigações laboratoriais; Suporte e cuidados aos familiares e pacientes; Reposição intravenosa; Suporte renal; Atividades gerenciais. Conclusão: Foi diagnosticado um alto nível de complexidade do paciente oncológico, além da demanda de cuidados assistenciais e biopsicossociais espirituais. Este instrumento possibilitará a mensuração da carga de trabalho da equipe de Enfermagem em Oncologia, o que pode contribuir para o dimensionamento de pessoal.

[Standardization of activities in an oncology surgical center according to nursing intervention classification]. / Padronização das atividades em centro cirúrgico oncológico segundo a classificação das intervençães de enfermagem.

This study was undertaken in a surgical center specializing in oncology, and it aimed to identify nursing activities performed during the perioperative period and to classify and validate intervention activities according to the Nursing Interventions Classification (NIC). A survey of activities was conducted using records and by direct observation of nursing care across four shifts. Activities were classified as NIC nursing interventions using the cross-mapping technique. The list of interventions was validated by nursing professionals in workshops. Forty-nine interventions were identified: 34 of direct care and 15 of indirect care. Identifying nursing interventions facilitates measuring the time spent in their execution, which is a fundamental variable in the quantification and qualification of nurses' workloads.

Registro de enfermagem nas reações adversas cutâneas ao meio de contraste iodado: sistematização de assistência / Nursing record in adverse skin reactions to iodinated contrast media: systematic assistance

As reações adversas cutâneas aos meios de contraste iodado não raro acontecem no setor de diagnóstico por imagem e é atribuída ao uso do contraste, que são substâncias capazes de melhorar a especificidade das imagens obtidas em exames radiológicos, pois permitem a diferenciação de estruturas e patologias vascularizadas das demais. Sua administração pode desencadear reações anafilactóide que são nocivas, às vezes fatais, ocorrem em uma minoria dos indivíduos. O estudo tem como objetivo principal, elaborar sistematização de identificação de Reações Adversas Cutânea ao meio de Contraste Iodado, de fom1a padronizada. Para o alcance dessa padronização está sendo construido wn instrumento para identificação dessas reações em pacientes em tratamento oncológico. A sistematização da identificação das reações cutâneas aos meios de contraste iodados será implementada no setor de diagnóstico por imagem do INCA / HCII. Para alcançar e assegurar cuidados efetivos ao cliente foi proposto um instrumento que possibilitará maior eficácia da identificação com interpretação comum, como uma prática confiável baseada na literatura que descreve os tipos de reações cutâneas aos meios de contrastes iodados. Esse trabalho de sistematização de condutas apresentará uma descrição detalhada dos tipos de reações que podem ocorrer após uso destes meios de contraste iodado, pois essas reações alérgicas aos meios de contraste, apesar de pouco freqüentes (11400.000) são inevitáveis, podendo variar em severidade, e podendo ocorrer após uma única administração ou após múltiplas. Com esse instrumento pretendemos facilitar a identificação do desfecho, contribuir para uma assistência mais qualificada e especializada ao cliente que se submete a exame contrastado no setor de radiodiagnóstico do HC II / INCA / MS.

The role of licensed nursing personnel in radiation oncology part B: integrating the ambulatory care nursing conceptual framework.

PURPOSE/OBJECTIVES: To describe the professional opportunities for licensed nursing personnel in radiation oncology within the conceptual framework developed for ambulatory care nurses by the American Academy of Ambulatory Care Nursing (AAACN). DATA SOURCES: Published articles and books. DATA SYNTHESIS: Using AAACN's framework, the researchers identified three roles that are part of every ambulatory care nurse's practice and can be readily customized to radiation oncology: an organizational/systems role, a professional role, and a clinical nursing role. Incorporating the described framework into a radiation oncology nurse's job description can lead to maximizing the use of the professional staff member within the radiation oncology department. This level of professional utilization and validation of the radiation oncology nurse will lead not only to improved patient outcomes but also to greater professional satisfaction, resulting in improved retention. CONCLUSIONS: The complexity of oncology therapies demands expert oncology nurses. This clearly is recognized in medical oncology, and patients with cancer who are being treated with radiation are no less important. To optimize patient care and therapeutic outcomes, the integration of nursing in all aspects of the radiation treatment continuum is essential. IMPLICATIONS FOR NURSING: Radiation oncology nursing is an evolving subspecialty. Nurses can use the information in this article to evaluate their current roles and individual potential for further professional growth.

[Nature and classification of nursing interventions in an adult outpatient clinic for chemotherapy]. / Natureza e classificação das intervenções de enferma gem em ambulatório de quimioterapia de adultos.

The purpose of the present descriptive study was to identify, through a retrospective analysis of records, the nature of nursing interventions as well as to establish the relationship between the nature of these interventions and the problems found. The sample was formed by 184 records of patients in their first nursing consultation at the Adult Chemotherapy Outpatient Unit of Hospital São Paulo from January to June, 1997; 37 records were selected at random: 19 male and 18 female patients. Results showed the predominance of interventions centered in patients' psychobiological needs. Educative interventions were more frequently performed when related to patients psychosocial needs. The correspondence between the identified problems and proposed interventions was evidenced when the psychobiological needs were met.

The nursing interventions classification: a language to define nursing.

PURPOSE/OBJECTIVES: To discuss the Nursing Interventions Classification (NIC) framework and its relationship to oncology nursing. DATA SYNTHESIS: NIC is a standardized language that identifies all interventions performed by nurses. The three-tiered taxonomy consists of six domains, 27 classes, and 433 interventions with related nursing activities. Each intervention consists of a label describing the concept, the definition of the concept, and a set of representative activities or actions. CONCLUSIONS: Although differences exist in the core interventions identified by the Oncology Nursing Society and the Association of Pediatric Oncology Nurses as critical to their practice, the NIC research team, after surveying both organizations, found numerous similarities in the possibilities for clinical application. IMPLICATIONS FOR NURSING PRACTICE: NIC provides a standardized language to enable oncology nurses to describe and demonstrate their work and contributions to lawmakers, healthcare policy makers, and the public.

Differentiated interdisciplinary practice.

Differentiated nursing practice (DNP) has demonstrated positive outcomes for patients, practitioners, and healthcare organizations. By expanding the principles of DNP to an interdisciplinary model, members of the oncology program of Indiana University Medical Center found that these outcomes were magnified. Patients' access to healthcare services improved, as did their efficacy in self-care behaviors; practitioners reported improved role satisfaction and use of fellow team members; and lengths of hospitalization and premature readmissions were reduced.

Performance of current procedural terminology codes by oncology nurses: a report to the ONS board of directors.

At the request of the ONS Board of Directors, a survey was conducted to determine the degree to which oncology nurses performed services listed in the Physicians Current Procedural Terminology manual--services for which physicians are reimbursed. Using a format modeled on a similar study of nurses in general, 100 randomly selected ONS members were asked to describe the degree to which they performed a list of 90 coded procedures compiled by four oncology nurse experts. Response rate was 43%. Respondents, who were representative of the ONS membership on all demographic variables except education, performed an average of 32 of the procedures with very little, if any, direct physician supervision. Study results reflect trends found among nurses in general and raise important questions about patterns of reimbursement and healthcare delivery.