What Are the Unmet Supportive Care Needs of People Affected by Cancer: An Umbrella Systematic Review.

OBJECTIVE: The aim of this umbrella systematic review was to critically synthesize unmet supportive care needs of people affected by cancer. DATA SOURCES: The Joanna Briggs Institute (JBI) umbrella review method provided an overall examination of the body of evidence that was available in relation to the unmet supportive care needs among people living with cancer. All qualitative, quantitative, and mixed methods reviews were included irrespective of review design. Electronic databases were searched using a wide range of search terms. All records were managed using the software package Endnote X21 and uploaded to Covidence systematic review software. Duplication of records were removed. A preselection eligibility criterion was applied to all records. Data extraction and methodological quality assessment was conducted independently by two reviewers, and a meta-level narrative synthesis conducted. CONCLUSION: A total 30 systematic reviews were included representing a total of 666 publications globally. Irrespective of the type of cancer there were many commonalities in relation to the reported experiences of unmet supportive care needs, which therefore enables the development of targeted future clinical trials, clinical guidelines, and policy contribution. In descending order of frequency, the highest unmet supportive care needs were related to psychological/emotional (30 out of 30), health system/information (29 out of 30), interpersonal/intimacy (21 out of 30), social (20 out of 30), physical (19 out of 30), family (18 out of 30), practical (16 out of 30), daily living (10 out of 30), spiritual needs (8 out of 30), patient-clinician communication (8 out of 30), and cognitive needs (5 out of 30). IMPLICATIONS FOR NURSING PRACTICE: This umbrella review has underscored fundamental shortcomings in care delivery irrespective of the patient population and the type of cancer. People with cancer are continually reporting that their needs are not being met across many supportive care domains. It is time for change within the health care system and to full leverage multidisciplinary person-centered models of care to optimize recovery and survivorship experiences. In the meantime, policy makers and cancer care clinicians are encouraged to reflect on these findings to address individualized care needs.

Clinical Oncology Nursing: Will You Leave or Stay?

Anyone who works in clinical oncology care sees it, experiences it, or feels it on a daily basis: a real or perceived shortage of nurses and, specifically, experienced clinical oncology nurses.

BUILDING BLOCKS OF A SUCCESSFUL ONCOLOGY NURSE ORIENTATION PROGRAM

Professional Development The purpose was to optimize oncology patient outcomes, an orientation program was developed providing the building blocks of success for new graduate nurses in an inpatient acute oncology unit. Providing a solid orientation experience for novice oncology nurses has become challenging since the onset of the COVID pandemic. Nurses currently entering the workforce come from schools that held classes and clinicals primarily online, leaving novice nurses to start their profession with minimal live clinical experience limiting the opportunity to learn and cultivate nursing and communication skills. Compounding this problem was the exodus of experienced oncology nursing staff that left to take on travel assignments, leaving novice nurses to be precepted by those with less experience making it harder for these novice nurses to make the transition from school to professional practice. To ensure novice oncology nurses build a solid foundation of knowledge and skills to provide safe, quality care and for unit retention, an orientation program was developed incorporating nursing competencies, communication skills, critical thinking, and oncology nursing knowledge. The orientation program is aligned with the hospital system's new graduate RN residency program and the additional classes were held on the unit level to supplement and augment the novice nurses' training. These classes included development of basic nursing skills, hospital specific procedures and protocols, foundational oncology knowledge, chemotherapy and immunotherapy. Various learning styles were implemented including hands-on practice skills labs, didactic presentations, flipped classroom learning, case studies, interactive games, and presentations by the novice nurses themselves. Upon completion of the orientation program, the unit supervisors then take over as coaches and mentors to ensure the novice nurses continue to be guided and supported as they start independent practice. Pre- and post- learning needs/skills/ knowledge assessments are analyzed to determine the effectiveness of interventions provided. Nurse retention rates and patient outcomes are monitored to evaluate the program's success. Recent challenges in the provision of education in nursing school and the high turnover rate of experienced nursing staff has hindered the transition from an educational to a professional setting for novice oncology nurses. A multi-faceted orientation program with plans for continued support is needed to ensure novice oncology nurses are prepared and skilled to provide safe, quality patient care and stay in their chosen professional field.

STANDARDIZING THE CLINIC NURSE ORIENTATION TO IMPROVE THE ONBOARDING EXPERIENCE

The shift of oncology care from the inpatient to outpatient setting has increased over the years, requiring an increased number of ambulatory oncology nurses. Ambulatory care at our academic, comprehensive cancer center is organized into sixteen, multispecialty disease team clinics, making nursing orientation challenging. The ambulatory nursing roles are multifaceted, requiring specialized knowledge of disease-specific diagnostic workup, management, and symptom profiles that patients experience over the course of their illness. Our institution lacked a standardized orientation process for clinic nurses, requiring a systematic restructuring of the onboarding experience to ensure competence, retention, and high-quality patient care. The purpose was to standardize the orientation process in the oncology clinics for nursing. A current state assessment was performed to understand the nursing roles in the sixteen teams. A gap analysis was conducted to understand the orientation process, staff needs, and best practice. Best practice included having a consistent preceptor while utilizing a multidimensional approach to the onboarding experience. A standardized orientation was developed based on nursing roles. Orientation templates were created for each team to ensure consistency in the onboarding process. Disease-specific onboarding experiences for each team were identified to build an orientation relevant to the clinic workflow. The nursing professional development specialist (NPDS) scheduled staff to observe the entire patient experience process;including new patient consultation, surgical procedure, inpatient care, and return visit. The NPDS also performed weekly check-ins to assess orientees progress. Vacancy and turnover rates were compared from May 2020 and July 2022. The May 2020 vacancy rate was 8.49% whereas July 2022 was 8.76%. The May 2020 turnover rate was 17.39% whereas July 2022 was 4.17%. A post-implementation survey was distributed to determine staff satisfaction with a 90% response rate. Respondents were practice nurses (32%), nurse coordinators (22%), and radiation nurses (22%). Common needs included increasing the shadow experiences specific to their disease team and observing their surgical and medical oncology counterparts. DISCUSSION: Creating a comprehensive orientation has allowed staff to understand ambulatory patient care. Changes to the onboarding process were made based on feedback and trends. While the vacancy rate remained unchanged, turnover has reduced drastically, suggesting that improved orientation positively affected nursing turnover. This data also suggests that the COVID pandemic may have had a greater impact on vacancy rates whereas turnover stabilized after meeting staff needs.

The Design And Development Of an Individualised Training Program For Metastatic Breast Cancer (MBC) Nursing Incorporating Remote And Onsite Learning Experiences During A Pandemic

Problem statement: Those diagnosed with metastatic breast cancer (MBC) have complex supportive care needs and the Australian Government funded 30 new dedicated MBC nurse roles across Australia in 2019 to better meet these needs. A pilot training program was designed to meet the individual learning needs of these nurses to increase their level of expertise in MBC nursing. Initially this program was designed to be delivered in-person, however recurrent COVID-19 restrictions required a change of approach to enable remote participation. Method(s): An expert working group created a curriculum of 20 learning modules addressing key elements of MBC nursing. From these modules a bespoke training program was designed for each participant to address their identified learning needs based on the validated Cancer Nurse Self-Assessment Tool for Metastatic Breast Cancer (CaN-SAT-MBC) and baseline interviews. During the pilot program, four intakes of two nurses (n=8) participated from August 2021 to June 2022. Participants completed a suite of online learning modules, 'attended' a 3-day clinical practicum, and commenced 12 months of bi-monthly clinical supervision for ongoing support. Participants attended the clinical practicum component either in-person or via a telepresence robot. Knowledge, skills and confidence in relation to MBC nursing are being measured by the CaN-SAT-MBC, and learner goals, expectations and experiences are being explored via qualitative interviews at three-time intervals: pre-training;post-practicum;and 12 months post-clinical supervision. Result(s): The final results of the evaluation will be available in 2023. It is hypothesised that nurses will report increased knowledge, skills and confidence in the areas of MBC nursing relevant to their identified learning needs following completion of the training program. Furthermore, it is also hypothesised that remote participation using robot technology will offer an equivalent learning experience to in-person training in this current pandemic environment. Conclusion(s): This study will test an individualised and innovative approach to breast cancer nurse education that may be utilised across Australia to upskill nurses in the provision of supportive care to those with MBC. There is potential for wide-spread adoption of robot technology for cancer education across Australia and beyond. Disclosure of interest: This project is partially funded by Astra ZenecaCopyright © 2022

CREATING A SAFE SPACE: PROTECTING ONCOLOGY PATIENTS RECEIVING CANCER TREATMENT DURING A COVID-19 INFECTION

Coordination of Care Since the COVID-19 pandemic unfolded, strains on the healthcare system have been widespread and pervasive (Kumar & Dey, 2020). At times, this crisis has put the oncology patient in a particularly unique position. As oncology care is a time-sensitive endeavor, treatment delays are critical to mitigate against and understand (Du et al., 2022). Delays or interruptions in cancer treatment can lead to progressive symptoms and worsened survival (Kumar & Dey, 2020). In addition, psychological implications for cancer patients are prominent (Dermody & Shuman, 2022). In the beginning of the pandemic, oncology patients who tested positive for COVID-19 were admitted to a respiratory isolation area in the hospital system not specialized in oncology, to provide physical separation from other vulnerable oncology patients in the cancer hospital. As a result, specialized oncologic treatments were not always available, which caused potential delays in necessary interventions. The aim of this project was to create a safe space for oncology patients, with an active COVID-19 infection, who additionally required timely oncologic treatments requiring an inpatient admission (acute leukemia, CAR T-cell administration, stem cell transplant, surgical intervention). The cancer hospital designed a 9-bed HEPA-filtrated area, with five rooms capable of being converted into ICU rooms for critically-ill patients. This area was termed the "Respiratory Isolation Flex Unit (RIFU)." Nursing leadership developed guidelines and policies around its appropriate use to ensure patient safety. Not only was a physical space required to allow for these types of admissions, but appropriate nursing specialty was vital as well. Institutional processes were developed to allow for nursing staff who were specialty trained in chemotherapy, critical care, stem cell transplant, etc. to be available for these patients. Cancer patients with a positive COVID-19 test upon admission were appropriately assigned to the RIFU and able to receive timely treatment, education, and monitoring with specialty trained nursing staff. Nursing staff had positive experiences caring for this unique patient population and collaborated to ensure a consistent "patient first" mentality. These innovative solutions allowed the cancer hospital to rise to the occasion and provide essential oncology treatments during these unprecedented times to patients with active COVID-19 infections. By preventing delays in important treatments and allowing for continued specialized care, we strived to positively impact outcomes and patient experiences.

BUILDING FUTURE ONCOLOGY NURSES WITH A NURSE TECHNICIAN PROGRAM

The COVID-19 pandemic created limited hands-on clinical experience for nursing students due to challenging staffing shortages and restrictions of non-essential personnel. Future nurses require engagement with patient care to develop hands-on skills, cultivate clinical judgment and build critical thinking. The role of a nurse technician allows centers to hire students enrolled in an accredited nursing program into a nursing supportive role. Nurse technician programs can help with staffing needs while also providing opportunity for future nurses to learn the care of oncology patients. The purpose was to develop and implement a program for nurse technicians to be incorporated into care delivery for patients in an ambulatory oncology clinical setting. An NCI-designated cancer care center identified an opportunity to leverage nurse technicians originally brought into the temporary vaccination clinic to transition to a formal oncology nurse technician role. The staff education team partnered with clinic leaders to assess needs and feasibility for the nurse technician role and partnered with local universities to recruit nursing students interested in oncology to apply to the program. Upon closure of the vaccine clinic, two junior nursing student technicians were retained and transitioned into hands-on patient care in ambulatory oncology clinics. A comprehensive orientation plan was built for subsequent nurse technician cohorts to assist registered nurses in the specialized care of oncology patients. The first cohort of nurse technicians were hired to assist in a temporary vaccine clinic in March 2021 (6). Two subsequent cohorts were hired in January 2022 (4) and June 2022 (4) to exclusively train into Infusion and Bone Marrow Transplant clinics. Of the 14 total nurse technicians hired between March 2021 and June 2022, 7 have graduated nursing school and obtained their RN licenses. Upon follow up with these 7 graduates, 5 (71%) were hired into oncology nursing roles upon graduation. Previous nursing supportive roles in the center only included certified nursing assistants and medical assistants. Incorporating nurse technicians is an innovative approach that has mitigated nursing support staffing shortages while providing future nurses with hands-on patient care experience at a time when clinical exposure has been seriously limited by the pandemic. Although nurse technicians are temporary roles while candidates complete nursing school, the program has demonstrated promising recruitment opportunity to captivate and inspire the next generation of future oncology nurses.

The current developments in oncology nursing: A review

Cancer has become one of the major causes of death in the growing world population, affecting people irrespective of their age, sex and culture. Cancer diagnosis and therapy is a distressing procedure and affects the physical, emotional and mental well-being of the patient. Many studies have reported that cancer has a long-term impact on patient's lives leading to mood dysfunction, heart problems and chemotherapy toxicity. Modern-day healthcare systems are moving towards a patient-oriented approach and are designed around the patient's well-being, needs and preferences. Oncology nurses form the fundamental part of this system and provide the patient with the much-needed care, support and hope for life. Oncology nursing has developed and evolved briefly in the recent few decades due to the advancement in treatment procedures. As cancer care continues to progress, nurses play a vital role in the field of oncology. Specialized oncology nurses are providing clinical care, or as nurse researchers leading revolutionary oncology research. The future of oncology nursing is optimistic. Nursing care for cancer patients not only requires guidance through medication and treatment, but also offers encouragement and motivation to the patients. The present review provides an insight into the nursing care of cancer patients, its brief history, advancements and the current practices of oncology nursing. Future prospects of oncology nursing have also been discussed in detail.Copyright © 2022, Kuwait Medical Association. All rights reserved.

NURSE MANAGER CNS PARTNERSHIP FOR QUALITY ROUNDING

With the stresses of Covid-19 and challenges with staffing, our oncology medical-surgical unit saw a slip in our nurse sensitive indicator quality metrics. A few interventions were put into place that helped for a short time but didn't take traction. The Nurse Manager (NM) and Clinical Nurse Specialist (CNS) looked for evidence- based ideas to get the quality metrics to below the National Database of Nursing Quality Indicators (NDNQI) benchmark targets. Using the Define, Measure, Analyze, Improve, Control (DMAIC) quality improvement methodology we put into place a plan to do weekly quality improvement rounds. The purpose of the quality rounds by the NM and CNS is to determine if preventative measures are properly in place and to re-enforce education to the patient and family. Follow up can also be provided to the nursing staff about measures not in place or not yet completed. Feedback to the staff can be provided in real time. Each week an appointment is sent so there is dedicated time for the rounds on both the NM and CNS calendar. Determination of which patients to see is based on presence of a central line, foley catheter, Braden score below 18 and being a fall risk. There are several items we are looking for when in the room. For example, when rounding on a patient who is at a risk for falling, we check that the bed alarm is on and plugged in correctly, the floor is free from any tripping hazards, the bedside table with frequently needed items is within arm's reach as is the call light and we re-enforce to call for help before getting out of bed. If we find items not in place, e.g., the bed alarm is not turned on, we turn the alarm on and follow up with the nursing staff. Currently, the quality rounds have been in place for almost two months. Since that time there have been two falls, no pressure injuries, no central line associated blood stream infections (CLABSI) nor any catheter associated urinary tract infections (CAUTI). We will continue to monitor effectiveness of rounding. Oncology patients are at a higher risk of infection and injury. By hard wiring interventions, we can prevent complications, decrease hospital length of stay and improve quality of life.

IMPROVING NURSING ASSISTANTS' KNOWLEDGE, COMFORT AND COMMUNICATION WITH SAFE HANDLING PRECAUTIONS

Oncology nursing assistants (NAs) provide intimate personal care for cancer patients, increasing their risk for exposure to hazardous drugs in patients' bodily fluid. Their knowledge and comfort with safe handling is paramount to protect staff and the environment from a potential hazardous drug contamination. However, since the COVID-19 pandemic, inpatient NAs at our National Cancer Institute (NCI) Designated Comprehensive Cancer Center only received safe handling education via our online education system. The COVID-related change in educating staff precipitated a knowledge gap for NAs with safe handling guidelines. Furthermore, nursing staff rarely communicated safe handling precautions for patients on oral medications or outpatient IV chemotherapy. The communication breakdown from nurses to NA placed an undue exposure risk to NAs, who are an integral part of the oncology care team. The purpose of this quality improvement project was to provide comprehensive didactic and hands-on training to NAs on our medical oncology unit to improve staff knowledge, comfort and communication with safe handling precautions. Eighteen NAs completed an anonymous survey to determine baseline knowledge of and comfort level with safe handling. The seven-question survey was developed by the unit safe handling champion and Clinical Nurse Specialist to assess knowledge, comfort and communication of safe handling precautions. Mandatory education included didactic and hands-on review of safe handling guidelines such as: communication of chemotherapy precautions;donning and doffing;proper disposal of wastes, contaminated linen and personal protective equipment;and chemotherapy spill response. NA comfort level was assessed using a single item Likert scale ranging from 1 (not at all comfortable) to 5 (very comfortable). NA communication was assessed using two multiple select questions addressing peer to peer communication and precaution signs in rooms. Four questions assessed NA knowledge of location and use of PPE, waste disposal and duration of safe handling precautions. Three month reassessment showed comfort level improved from average 2.6 to 4.3. Thirty-eight percent of initial responders stated they never received communication about safe handling precautions, which decreased to 0% after education. NA knowledge also improved across all four questions. NAs are responsible for disposal of potentially contaminated bodily fluids. Lack of communication and knowledge of safe handling practices places undue exposure risk to staff and environment. Ensuring proper NA training improves engagement and empowers oncology nursing assistants to improve knowledge, communication and comfort with safe handling guidelines.

BRIDGING THE ONCOLOGY NURSES' KNOWLEDGE GAP ON PSYCHOSOCIAL NEEDS OF PATIENTS WITH CANCER

Oncology patients face various psychosocial issues, from initial cancer diagnosis, during treatment, survivorship, and end of life. Education is needed to address the psychosocial issues experienced by oncology patients. The results of an educational needs assessment indicated 99% of nurses showed interest in gaining enhanced knowledge of psychosocial needs in oncology patients. To bridge the knowledge gap, solid tumor nursing educators developed a psychosocial course, empowering nurses to address patients' psychosocial needs through their cancer continuum. The purpose was to develop an educational offering that would enhance nurses' knowledge of psychosocial issues, interventions, and available resources to support the needs of oncology patients. The solid tumor team conducted monthly meetings to determine the agenda and content experts. The course content was developed in collaboration with an interprofessional team (social work, nutrition, ethics, supportive care, etc.) using evidence-based materials. The subject experts developed content and reviewed for approval by nursing educators. The Nursing Continuing Professional Development (NCPD) application was submitted and approved for 7.5 NCPD hours. The first class was piloted in the solid tumor cohort and then rolled out to all the cohorts in the institution. A total of 214 participants attended the three virtual courses. The analysis of post-course evaluation for the three courses showed that 96% - 99% of participants said that learning goals for the course were met. Additionally, 96% - 99% of participants said they gained new knowledge and competence in the psychosocial assessment, implementation, and provision of holistic care for oncology patients. The participants' evaluation feedback shows the course goals were met supporting the course significance to oncology nurses. Staff interest, attendance, and participation were concerns in the beginning of the course due to Covid and staffing issues. However, with the use of virtual technology, the first class accommodated 100 participants. Additionally, the availability of speakers from different interdisciplinary team members was a concern, but the speakers were interested in providing virtual presentations to meet the needs of our nurses. This course decreases the gap in knowledge related to care of the Psychosocial needs of oncological patients. Furthermore, it encourages and prepares nurses to enhance their skills for effective assessment, implementation, and provision of holistic care for oncology patient.

Black Americans' Perceptions of Communication and Other Factors during Oncology Care Virtual Visits: Presenter(s): Jennifer Elston Lafata, University of North Carolina at Chapel Hill, United States

During the COVID-19 pandemic, many oncology practices began offering virtual visits via video and/or telephone. How such visits are perceived by Black patients, who have historically faced access barriers and poorer cancer outcomes, is not known. We elicited Black patients' perceptions of and experiences with oncology virtual visits. We conducted in-depth, semi-structured telephone interviews with Black adults receiving oncology care for head and neck cancer, prostate cancer, and multiple myeloma between 6/1/19 - 3/20/21 from two US-based academic health systems. The interview guide elicited virtual visit perceptions and experiences within predefined themes (e.g., ease of use, usefulness, communication quality, appropriateness). Interviews were audio-recorded, transcribed, and coded for a priori themes and new ones identified during data immersion. Two trained research assistants coded transcripts, using Atlas.ti for data management. Forty-nine adults completed an interview between 9/2021 and 2/2022 (n=16 head and neck, n=16 prostate, and n=17 multiple myeloma);mean age 63 years (range: 39-75), 53% male, and 77% ever having a virtual visit. Participants indicated communication with their doctor and privacy was comparable between in-person and virtual visits but expressed feeling less human connectedness during virtual visits. They cited convenience advantages (e.g., being home, flexibility when physicians run late, and reduced travel barriers);however, they also reported preferring in-person visits, due to wanting doctors to conduct physical examinations or needing in-person testing. Participants described wanting a choice regarding visit type and valued it when physicians articulated the option to conduct an in-person visit (i.e., patient-centeredness in scheduling). To overcome technical barriers to virtual visit attendance, patients received assistance from adult children, physicians, and other support. We identified barriers to and facilitators of virtual visit use among Black patients receiving cancer care. [ABSTRACT FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancer nurses face ‘perfect storm' after COVID pandemic

Cancer nurses are weathering a 'perfect storm' of challenges as they face severe workforce shortages and struggle to recover from the pandemic.

Guidelines for teleconsultations

Introduction: The COVID-19 pandemic forced oncology nurses to deliver more consultations by telephone (teleconsultations). Nurses in Switzerland are in general not trained to provide teleconsultations, making this change of practice a considerable challenge. The Academic Society Oncology Nursing invited health care professionals to webinars in French and German to discuss their experiences related to COVID-19 policies. Method(s): Members of the Academic Society searched for international guidelines and already implemented digital tools to facilitate teleconsulta-tions in oncological settings. Overall, ten national and international health care experts including nurses, an oncologist, and an expert for telephone consultations participated at two webinars. The same outline was used in French and German and both webinars were video recorded. Result(s): COVID-19 pandemic policies drove an increase in teleconsulta-tions. Guidelines for telephone triage from the Oncology Nursing Society (ONS) in the USA and in the UK (UKONS) incorporated procedures to assess COVID-19 symptoms and to defne patient referrals based on local health system capacities. In France, the Gustave Roussy Institute created the CAPRI-COVID program to facilitate the remote monitoring of cancer patients during the COVID-19 pandemic. In Switzerland, nurses used local guidelines implemented for follow-up consultations by telephone to support cancer patient adherence to treatment and to assess symptom trajectories, to structure their teleconsultations. The assessment of COVID-19 symptoms was not always included. The sudden change to support patients remotely was challenging when no guidelines or standards for this kind of support were already in place. Documenting tele-consultations was difcult when no electronic documentation system was implemented. The reimbursement of nursing teleconsultations was a major, important barrier nurses faced, leading to unpaid provided services. Conclusion(s): The federal health system in Switzerland has provided no national recommendations for nursing teleconsultations. However, ONS and UKONS guidelines could inform the development of evidence based recommendations for oncology nursing teleconsultations in Switzerland. The Academic Society Oncology Nursing will take an initiative to discuss reimbursement of nursing teleconsultations with Swiss stakeholders including health care professionals and policy makers.

Guidelines for teleconsultations

Introduction: The COVID-19 pandemic forced oncology nurses to deliver more consultations by telephone (teleconsultations). Nurses in Switzerland are in general not trained to provide teleconsultations, making this change of practice a considerable challenge. The Academic Society Oncology Nursing invited health care professionals to webinars in French and German to discuss their experiences related to COVID-19 policies. Method(s): Members of the Academic Society searched for international guidelines and already implemented digital tools to facilitate teleconsulta-tions in oncological settings. Overall, ten national and international health care experts including nurses, an oncologist, and an expert for telephone consultations participated at two webinars. The same outline was used in French and German and both webinars were video recorded. Result(s): COVID-19 pandemic policies drove an increase in teleconsulta-tions. Guidelines for telephone triage from the Oncology Nursing Society (ONS) in the USA and in the UK (UKONS) incorporated procedures to assess COVID-19 symptoms and to defne patient referrals based on local health system capacities. In France, the Gustave Roussy Institute created the CAPRI-COVID program to facilitate the remote monitoring of cancer patients during the COVID-19 pandemic. In Switzerland, nurses used local guidelines implemented for follow-up consultations by telephone to support cancer patient adherence to treatment and to assess symptom trajectories, to structure their teleconsultations. The assessment of COVID-19 symptoms was not always included. The sudden change to support patients remotely was challenging when no guidelines or standards for this kind of support were already in place. Documenting tele-consultations was difcult when no electronic documentation system was implemented. The reimbursement of nursing teleconsultations was a major, important barrier nurses faced, leading to unpaid provided services. Conclusion(s): The federal health system in Switzerland has provided no national recommendations for nursing teleconsultations. However, ONS and UKONS guidelines could inform the development of evidence based recommendations for oncology nursing teleconsultations in Switzerland. The Academic Society Oncology Nursing will take an initiative to discuss reimbursement of nursing teleconsultations with Swiss stakeholders including health care professionals and policy makers.

Understanding the experiences of cancer patients referred for a clinical trial during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic affected cancer patients regardless of the stage of their diagnosis or treatment. AIMS: To understand the experiences of cancer patients who were referred for a clinical trial at that time. METHOD: Cancer patients who attended their initial research outpatient appointment to discuss the possibility of taking part in a clinical trial were asked to complete the Generalised Anxiety Disorder Assessment questionnaire, and take part in semi-structured interviews. FINDINGS: Data indicated that, on average, patients had moderate levels of anxiety. Three major themes emerged from patients' interviews, which gave an insight into what they experienced during this challenging period. CONCLUSION: This study gives an insight into the experiences of cancer patients who were referred for a clinical trial at the height of the COVID-19 pandemic. It illustrated the impact of social distancing and the effect of virus-related fear on cancer patients' mental health.

Pandemic-Related Innovations in Oncology Nursing Research: Seeking the Positive: lthough COVID-19 was a major setback for completing and initiating projects, it ushered in a new era for investigators

The article focuses on the scientists across industry, academic and healthcare settings that were forced to halt their ongoing research studies because of isolation mandates associated with the management of contagion in the COVID-19 pandemic. Topics include examines for many scientists, this unprecedented stoppage continued for many months and not only disrupted preexisting studies but delayed the development of new work.

Scientific Publications on Nursing for COVID-19 in Patients With Cancer: Scoping Review.

BACKGROUND: The needs of patients with cancer must be met, especially in times of crisis. The advent of the pandemic triggered a series of strategic actions by the nursing team to preserve the health of patients and professionals-hence the importance of studies on nursing care actions provided to patients with cancer during the COVID-19 pandemic. It is known that these patients are susceptible to severe COVID-19. However, no previous review has summarized the findings of scientific studies on nursing for COVID-19 in patients with cancer. OBJECTIVE: This study aims to map the topics addressed in scientific studies on nursing for COVID-19 in patients with cancer. METHODS: A scoping review was conducted using the methodology described in the Joanna Briggs Institute Reviewers' Manual 2015. The research question was elaborated using the population, concept, and context framework: What topics have been studied in nursing publications about COVID-19 in adult patients with cancer? The searches were carried out in 8 databases between April and November 2021 without time restrictions. RESULTS: In total, 973 publications were identified using the search strategies in the databases, and 12 papers were retrieved by consulting the references. A total of 31 (3.2%) publications were included in the final analysis, generating 4 thematic categories on the subject: "restructuring the services: how oncology nursing was adapted during the pandemic," "experiences of patients and performance of the nursing team during the COVID-19 pandemic," "protocols and recommendations for dealing with the COVID-19 pandemic," and "challenges and the role of oncology nurses facing the COVID-19 pandemic." CONCLUSIONS: Several strategies used by oncology nurses to face the COVID-19 pandemic in the international scenario were identified. Reports about the restructuring of services and the team's reactions to the pandemic predominated. However, there is a lack of reports regarding emotional support strategies for health care professionals. Another gap identified was the scarcity of clinical studies on the activities developed by oncology nurses. Therefore, there is a need for clinical research in the oncology area and emotional coping strategies to support oncology nurses.