ABSTRACT
Introduction: The COVID-19 pandemic required health services to find novel approaches to provide facilitate timely review for patients receiving systemic cancer therapies (SCT). Telehealth permits greater efficiency and access and visual assessment of specific adverse effects. A pilot Telehealth Cancer Support Nurse Review Clinic (TCSN-RC) was established. This service complements existing cancer support nurse service (CSNS). The clinic is staffed by advanced practice oncology nurses, with care guided by a triage tool and an established referral pathway. Aim: To explore the use of telehealth to enhance the CSNS in providing rapid review for symptom and toxicity management of patients receiving SCT. Method: Quality improvement methodology has been used to evaluate and improve the TCSN-RC. Patient and CSN (Cancer Support Nurse) experience survey questionnaires were developed and analysed. Regular project team meetings reviewing interim results has allowed for improvement of processes. Results : Since the commencement in October 2020, there have been 18 CSN telehealth consultations. Twenty-eight per cent (n = 5) of patients and 100% (n = 4) of Cancer Support Nurses (CSN) have completed an evaluation survey. All patients (n = 5) strongly agreed or agreed they felt confident using the technology, the telehealth saved them travel time, the need to see their GP and enabled them to better manage their own symptoms. Participant reported feeling reassured by seeing a familiar face and prompt service from knowledgeable nurses. They reported having good video connections, could see and hear well. All CSN's (n = 4) strongly agreed or agreed that the telehealth consultation was convenient for them, helped to conduct better symptom assessments and were comfortable with telehealth technology Conclusion: Early results indicate the TCSN-RC service is a valuable addition to the CSN's in the delivering symptom and urgent clinical review with ongoing evaluation of results and potential for improvements in process as the study continue.
ABSTRACT
Aims: This study aimed to investigate the impact of a 'Community of Practice' (CoP) intervention on stress, burnout, resilience, job satisfaction and mindfulness among cancer clinical nurse consultants (CNCs) working in a large metropolitan cancer centre. The experiences of CoP participants were also explored. Methods : A consecutive mixed methods approach incorporating a one-group pre and post-test intervention design with qualitative interviews was employed. The intervention consisted of six CoP meetings incorporating structured professional development, networking and mindfulness training. The first CoP was delivered in-person with the remainder online due to COVID-19 restrictions. Participants completed validated and reliable questionnaires at baseline data (T0), after the 4th CoP (T2) and after the 6th CoP (T2) with data analysed using descriptive and inferential statistics. Qualitative interviews were conducted online and data were analysed thematically. Results : Thirteen CNCs completed the measures at all three time points and five contributed to qualitative interviews. No statistically significant differences in job satisfaction, burnout, stress, resilience, or mindfulness were observed between measures except for a decline in personal satisfaction from baseline to T1 and a decline in satisfaction with pay between T1 and T2. Across the study period, participants reported fair-to-good overall job satisfaction, high resilience, moderate mindfulness, moderately low stress and low levels of burnout. Five main themes were inductively derived from the qualitative data: Challenges of role;Existing and desired support;Introducing a community of practice;Importance of connection and relationship building;Acknowledgement, support and promotion of role. Conclusion: The CoP brought cancer CNCs in siloed but similar roles together to learn and connect. The CoP was conducted during a global pandemic when nurses faced unprecedented challenges in their roles. Despite this, participants in the CoP were able to maintain their good baseline levels of job satisfaction, resilience, mindfulness, stress and burnout.