ABSTRACT
PURPOSE/OBJECTIVES: To examine the impact on continuity of nursing care delivered by a pivot nurse in oncology to improve symptom relief and outcomes for patients with lung or breast cancer. DESIGN: Randomized controlled trial in which participants were randomly assigned to an intervention group (n = 93) with care by a pivot nurse in oncology and usual care by clinic nurses or to a control group (n = 97) with usual care only. SETTING: Three outpatient ambulatory oncology clinics in a large university health center in Quebec, Canada. SAMPLE: 113 patients with lung cancer and 77 patients with breast cancer. METHODS: Participants in both groups completed the Symptom Distress Scale, Brief Fatigue Inventory, and Functional Assessment of Cancer Therapy Scale-General version 4 at eight intervals over six months. Healthcare usage was evaluated through a review of hospital records. MAIN RESEARCH VARIABLES: Symptom distress, fatigue level, quality of life, and healthcare usage. FINDINGS: Researchers found no significant differences in symptom distress, fatigue, quality of life, and healthcare usage between groups. CONCLUSIONS: The new nursing role did not have an impact on the patient outcomes under study. IMPLICATIONS FOR NURSING: Experienced nurses with specialized knowledge of oncology symptom assessment and management may reduce the symptom burden experienced by ambulatory patients with breast or lung cancer during active treatment.
Subject(s)
Breast Neoplasms/nursing , Fatigue/nursing , Health Resources/statistics & numerical data , Lung Neoplasms/nursing , Oncology Nursing/organization & administration , Aged , Breast Neoplasms/complications , Breast Neoplasms/psychology , Breast Neoplasms/therapy , Cancer Care Facilities , Continuity of Patient Care , Emergencies/epidemiology , Fatigue/etiology , Fatigue/psychology , Female , Follow-Up Studies , Hospitalization/statistics & numerical data , Hospitals, University , Humans , Lung Neoplasms/complications , Lung Neoplasms/psychology , Lung Neoplasms/therapy , Male , Middle Aged , Models, Nursing , Nursing Care , Outpatient Clinics, Hospital , Quality of Life , Quebec , Severity of Illness IndexABSTRACT
PURPOSE: A major focus of clinical nurse specialist nursing practice is the integration of research findings into practice. The purpose of this study was to describe strategies used to facilitate research utilization (RU) by nurses in a practice setting. DESIGN: This multiple-case study identified the strategies that clinical nurse specialists and master's degree-prepared nurse educators, working collaboratively, used to facilitate RU. SETTING/SAMPLE: The setting included 8 units in 4 sites of a university hospital with all willing nurses participating. METHODS: Open-ended focus groups and individual interviews and observational sessions were conducted using investigator-designed interview guides. Comprehensive qualitative analysis led to identification of categories and themes related to RU and the unit culture that supported it. FINDINGS: Findings demonstrated that strategies to facilitate RU by staff at the unit level included conducting original research, supporting nurses participating in research, assessing and meeting staff learning needs, promoting staff attendance at conferences, stimulating goal-setting for presentations and publications, encouraging and responding to new ideas, questioning practice and stimulating inquiry, capitalizing on expertise in research knowledge and skills, and generating information and material resources. Characteristics of unit culture were linked to varying degrees of success with these strategies. The interplay of strategies with unit culture and research-based practice is described. CONCLUSION: A wide repertoire of strategies is needed to facilitate RU, and the outcome of these strategies is influenced by the unit culture. IMPLICATIONS FOR PRACTICE: Consideration of the findings and the scope of the strategies used by nurses in the study can help clinical nurse specialist and other nursing leaders facilitate the building of practice on research.
Subject(s)
Diffusion of Innovation , Evidence-Based Medicine , Nurse Clinicians , Nursing Research , Nursing Staff, Hospital , Evidence-Based Medicine/organization & administration , Focus Groups , Humans , Nursing Staff, Hospital/organization & administration , Organizational Case Studies , Organizational Culture , QuebecABSTRACT
The purpose of this multiple-case study of research utilization (RU) was to examine whether and how nursing practices in acute-care units are built on research and to identify potential explanations for the observed patterns. Open-ended data were collected from staff nurses and nursing leaders on 8 acute-care units through interviews and observation. RU varied within and across units, but unit culture emerged as the principal factor linked to patterns of RU. Unit-culture themes that formed the links were harmony of research perspective, motivation to learn, goal orientation, creativity, critical inquiry, mutual respect, and maximization of resources. The findings provide a rich description that could serve as a basis for self-assessment of unit culture in inpatient and outpatient acute-care units.
