Shannon Phillips, RN, MS, AOCNS1, Catherine Lyons, RN, MS, CNAA1, Charlene Peters, RN1, Colleen Tantalo, RN1, Kathleen Castellano, RN1, Gail L. Ingersoll, EdD, FAAN2, and Daniel Hatch2. (1) Cancer Center, University of Rochester Medical Center, Rochester, NY, USA, (2) Nursing Practice, University of Rochester Medical Center, Rochester, NY, USA
Nursing care requirements for patients undergoing cancer treatment are focused on both the safe administration of therapy and the patient’s biopsychosocial response to disease. Depending on the treatment ordered, the stage of the disease, and the social and individual circumstances of the patient, nursing care needs can vary considerably from patient to patient. Understanding these levels of intensity and their impact on allocation of qualified nursing resources is essential to the delivery of safe, effective nursing care.
A study was undertaken in a large ambulatory Cancer Center to: determine the validity and utility of an ambulatory patient intensity scale for use with patients receiving standard cancer management therapies; describe the amount (in minutes) and complexity of nursing care provided to cancer patients treated in an outpatient setting; and identify potential additional indicators required for assessing standard therapy cancer patients’ care delivery intensity. A previously validated data collection tool in use at several cancer centers was used to collect information during 1,367 patient visits concerning the types and frequency of nursing services provided patients. Level of nursing intensity ranged from I through VI, with less intense activities requiring less than 15 minutes of nursing time and more intense activities requiring greater than 241 minutes. The analysis of data determined that nursing intensity and resource needs varied from day to day, with certain days of the week requiring additional resources beyond what was currently available. Data also demonstrated periods in which more complex patients were assigned to less experienced nurses, which was contrary to the desired staffing approach. Findings from this study were presented to the medical center’s budget review committee with a recommendation for adding nursing personnel to care for patients in the Cancer Center. With data to demonstrate the need, the request was granted by the budget review board.