Improving the Nursing Management of Patients
Improving the Nursing Management of Patients
This article reports on an action research project conducted in one hematology-oncology day unit in Queensland, Australia. The project consisted of three phases, each of which included observation, reflection, action, and evaluation. The first phase calculated the amount of time and the dedicated nursing hours required to administer the different chemotherapeutic protocols to patients in a number of hematology-oncology day units in Southeast Queensland. The second phase changed the patient booking and staff allocation systems following an evaluation of process and outcome measures and a patient survey. The patient survey measured both generic satisfaction and satisfaction with symptom management. The third phase introduced and evaluated the effectiveness of primary nursing and increased emphasis on patient education. The first two changes brought about by the action research process improved patient wait time, patient satisfaction, and symptom management. The changes implemented in phases 1 and 2 increased the amount of time available for nurses to engage in psychosocial care. The increased emphasis on education in phase 3 did not significantly improve patient knowledge related to self-care or appropriate health professional referral. To improve patient education, the development and implementation of a self-care education program is recommended.
The hematology-oncology day unit (HODU) has been established to provide chemotherapy treatment, physician review, and psychological care for patients in an outpatient setting. The staff of one HODU in Queensland, Australia, became aware that the increasing diversification of the patients being treated in the HODU was causing a rise in the demand for service. This in turn was causing delays for patients and a possible reduction in the standard of care provided. The charge nurse was receiving more patient complaints, whereas the nurses were expressing their concerns about the level of care they were able to provide. In particular, there were concerns about patient waiting lists, the time patients had to wait on treatment days, patient symptom management, patient education, and the identification and management of chemotherapy complications.
The staff of the HODU decided both to investigate the extent of these problems and to pose solutions. Their first step was to contact the clinical nursing research unit of the hospital and to obtain advice on research design. After numerous consultations, it was agreed that using an action research approach would enable the nursing concerns to be explored more fully and appropriate changes in practice to be introduced and evaluated.
This article reports on an action research project conducted in one hematology-oncology day unit in Queensland, Australia. The project consisted of three phases, each of which included observation, reflection, action, and evaluation. The first phase calculated the amount of time and the dedicated nursing hours required to administer the different chemotherapeutic protocols to patients in a number of hematology-oncology day units in Southeast Queensland. The second phase changed the patient booking and staff allocation systems following an evaluation of process and outcome measures and a patient survey. The patient survey measured both generic satisfaction and satisfaction with symptom management. The third phase introduced and evaluated the effectiveness of primary nursing and increased emphasis on patient education. The first two changes brought about by the action research process improved patient wait time, patient satisfaction, and symptom management. The changes implemented in phases 1 and 2 increased the amount of time available for nurses to engage in psychosocial care. The increased emphasis on education in phase 3 did not significantly improve patient knowledge related to self-care or appropriate health professional referral. To improve patient education, the development and implementation of a self-care education program is recommended.
The hematology-oncology day unit (HODU) has been established to provide chemotherapy treatment, physician review, and psychological care for patients in an outpatient setting. The staff of one HODU in Queensland, Australia, became aware that the increasing diversification of the patients being treated in the HODU was causing a rise in the demand for service. This in turn was causing delays for patients and a possible reduction in the standard of care provided. The charge nurse was receiving more patient complaints, whereas the nurses were expressing their concerns about the level of care they were able to provide. In particular, there were concerns about patient waiting lists, the time patients had to wait on treatment days, patient symptom management, patient education, and the identification and management of chemotherapy complications.
The staff of the HODU decided both to investigate the extent of these problems and to pose solutions. Their first step was to contact the clinical nursing research unit of the hospital and to obtain advice on research design. After numerous consultations, it was agreed that using an action research approach would enable the nursing concerns to be explored more fully and appropriate changes in practice to be introduced and evaluated.
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