Addressing Incivility and Bullying in the Practice Environment.

OBJECTIVE: To identify knowledge related to incivility in the workplace, explore the impact that incivility can have on nursing and patient outcomes, and identify interventions to help promote a positive work environment. DATA SOURCES: Published literature, internet, books, and clinical guidelines. CONCLUSION: Incivility detracts from the caring environment of oncology care. Incivility can negatively affect oncology nurse's ability to work together as collaborative teams and may have detrimental consequences on patient outcomes. IMPLICATIONS FOR NURSING PRACTICE: Oncology nursing is a highly collaborative specialty; therefore, nurse leaders need to ensure all team members have the tools needed to mitigate workplace incivility.

Preparing Cancer Patients and Family Caregivers for Lung Surgery: Development of a Multimedia Self-Management Intervention.

The surgical treatment of lung malignancies often results in persistent symptoms, psychosocial distress, and decrements in quality of life (QOL) for cancer patients and their family caregivers (FCGs). The potential benefits of providing patients and FCGs with preparatory education that begins in the preoperative setting have been explored in multiple medical conditions, with positive impact observed on postoperative recovery, psychological distress, and QOL. However, few studies have explored the benefits of preparatory educational interventions to promote self-management in cancer surgery, including lung surgery. This paper describes the systematic approach used in the development of a multimedia self-management intervention to prepare cancer patients and their FCGs for lung surgery. Intervention development was informed by (1) contemporary published evidence on the impact of lung surgery on patients and FCG, (2) our previous research that explored QOL, symptoms, and caregiver burden after lung surgery, (3) the use of the chronic care self-management model (CCM) to guide intervention design, and (4) written comments and feedback from patients and FCGs that informed intervention development and refinement. Pilot-testing of the intervention is in process, and a future randomized trial will determine the efficacy of the intervention to improve patient, FCG, and system outcomes.

Leading Change: Implementation of a New Care Coordination Model.

Today's healthcare environment is characterized by a multitude of changes: acquisitions and mergers, streamlining of operations, restructuring and leadership shifts, new regulatory requirements with the 10th revision of the International Statistical Classification of Diseases and Related Health Problems, implementation and meaningful use, and advances in technology driven by the employment of electronic health records. The impact of these changes is complex and fraught with challenges in an industry that historically and culturally is cautious and slow to change. 
.

On the Scene: Developing a Nurse Care Coordinator Role at City of Hope.

We describe the development of an oncology solid tumor disease-focused care coordination model. Consistent with our strategic plan to provide patient- and family-centered care and to organize care around disease management teams, we developed the role of nurse care coordinator as an integral team member in our care delivery model. Managing a defined high-risk patient population across the care trajectory, these nurses provide stable points of contact and continuity for patients and families as they navigate the complex treatments and systems required to deliver cancer care. We describe role delineation and staffing models; role clarity between the role of the nurse care coordinator and the case manager; core curriculum development; the use of workflow management tools to support the touch points of the patient and members of the care team; and the incorporation of electronic medical records and data streams to inform the care delivery model. We identify measures that we will use to evaluate the success of our program.

Practice Innovations, Change Management, and Resilience in Oncology Care Settings.

Our commitment to advancing nursing practice and quality care for our patients must be at the forefront of our minds. Nursing's role in designing and implementing new innovations is integral to the advancement of healthcare delivery across the country.