Implementation Strategies to Support Evidence-Informed Symptom Management Among Outpatient Oncology Nurses: A Scoping Review Protocol

Introduction: Despite the availability of clinical practice guidelines for cancer symptom management, cancer care providers do not consistently utilize them in practice. Oncology nurses in outpatient settings are well-positioned to use established guidelines to inform symptom assessment and management; however, issues concerning inconsistent implementation persist. This scoping review aims to identify and describe the components of implementation strategies that have been used to enhance the adoption, implementation, and sustainability of symptom management guidelines among specialized and advanced oncology nurses in cancer-specific outpatient settings. Factors influencing guideline implementation will also be identified. Methods and analysis: This scoping review will follow Joanna Briggs Institute methodology. Electronic databases CINAHL, Embase, Emcare, MEDLINE(R), and grey literature sources will be searched for studies published in English since the year 2000. Primary studies and grey literature reports of any design that include specialized or advanced oncology nurses practicing in cancer-specific outpatient settings will be eligible. Sources describing implementation strategies to enhance the adoption, implementation, and sustainability of cancer symptom management guidelines and/or factors influencing implementation will be included. Two reviewers will independently screen for eligibility and extract data. Data extraction will be guided by the Consolidated Framework for Implementation Research (CFIR). Data will be analyzed descriptively and synthesized according to CFIR constructs. Results will be presented through tabular/diagrammatic formats and narrative summary. Ethics and dissemination: Ethics approval is not required for this scoping review. Planned knowledge translation activities include a national conference presentation, peer-reviewed publication, academic social media channels, and dissemination within local oncology nursing and patient networks.

Outcomes of Integrating Smart Phrase Interface Technology to Improve Cancer Symptom Management

ssessing cancer treatment-related symptoms is challenging for frontline telephone-triage nurses toggling multiple electronic health record (EHR) screens for information on toxicity-risk predictors while simultaneously providing over-the-phone emotional support. Decision-support tools embedded into computer-telephone interface software, called smart phrases, are not widely used nor empirically evaluated for usability and remote symptom management impact.

Reducing emergency department utilization for outpatient acute cancer symptoms: An integrative review on the advent of urgent cancer clinics

The purpose of this integrative literature review was to identify nursing research opportunities related to outpatient acute cancer symptom management within emerging urgent cancer clinics (UCCs). Patients with acute cancer symptoms (e.g., fevers, gastrointestinal disturbances, or uncontrolled pain) from ambulatory settings predominantly rely on emergency departments (EDs) for assessment and treatment. However, this model of care is no longer sustainable and emphasizes healthcare system inefficiencies. Urgent cancer clinics allow patients to have these symptoms treated by oncology experts within ambulatory cancer centres. Unfortunately, limited research on urgent cancer clinics both operationally and experientially makes it difficult for others to adopt this new model of care. The core questions that guided this integrative review were: 1) What is the state of the science regarding UCCs, and what differences exist when compared to EDs in the management of outpatient acute cancer symptoms? and 2) Where do UCCs exist around the world, and what is understood about UCCs related to clinic operations and staffing models?

Implementing Practice Guides to Improve Cancer Symptom Management in Homecare: A Comparative Case Study

Symptoms experienced by clients with cancer often occur at home and can become life-threatening, posing serious safety concerns. This study evaluated implementation of evidence-informed symptom practice guides to enhance quality of cancer symptom support by homecare nurses. A comparative case study was conducted using the Knowledge to Action Framework. Case were created for each of six agencies providing nursing care within a regional homecare authority. A team of researchers and knowledge users (e.g., managers, educators, family member): (1) assessed factors influencing practice guide use (survey, interviews) at six agencies, (2) adapted 15 practice guides for local use, (3) implemented with interventions to address barriers, and (4) monitored use. Analysis was within and across cases. Of six nursing agencies, one withdrew and five participated. In the baseline survey, 51% of nurses reported using guidelines but nurses did not describe using them in their current practice during the interviews. To overcome barriers, 489 nurses in five agencies were trained in how to use the practice guides, principles were established for documenting cancer symptom management, and practice guides were made available in various formats. Success with implementation varied across the participating cases. Chart audits conducted in three agencies revealed evidence of practice guide use for 16%, 22%, and 70% client visits, respectively. Implementation of evidence-informed practice guides in nursing required an approach tailored for each agency. Training, integration in documentation, and easy access to practice guides increased use for some nurses but ongoing support and reinforcement from nurse leaders is required.

Improving Cancer Outcomes for Vietnamese Speaking Migrants: A Mixed Methods Study

Background: Prompt diagnosis of symptomatic cancer has been shown to improve survival and quality of life. The time from noticing a bodily change and seeking medical help has been termed the 'symptom appraisal interval'. The processes people undertake during symptom appraisal are impacted by numerous factors, including culture. Aim: We aimed to explore culturally specific factors that impact symptom appraisal and help seeking for a cancer diagnosis in Vietnamese-speaking Australians and to develop a culturally relevant community-based symptom awareness campaign. Methods: We used a mixed methods approach to survey and interview people who had not experienced cancer and interviewed people with a recent diagnosis of cancer. We also tested campaign materials in focus groups and interviews with community members. Results: 28 people participated in the interview study and 65 completed surveys. We found poor symptom recognition and a prevailing Taoist or traditional Eastern model of health and illness. There was also a strong emphasis on being healthy for your family and fatalistic beliefs. Home remedies and Eastern medicine were commonly used for cancer symptom management and the people with cancer were shocked at their cancer diagnosis. Conclusion: The study findings were used to tailor a symptom awareness campaign for Vietnamese speaking communities to raise awareness of cancer symptoms and to prompt people to discuss symptoms with family and their general practitioner sooner to facilitate timely diagnosis and better outcomes.