Nevidjon B

Identifying and Addressing the Needs of Adolescents and Young Adults With Cancer: Summary of an Institute of Medicine Workshop

Cancer is the leading disease-related cause of death in adolescents and young adults (AYAs). This population faces many short- and long-term health and psychosocial consequences of cancer diagnosis and treatment, but many programs for cancer treatment, survivorship care, and psychosocial support do not focus on the specific needs of AYA cancer patients. Recognizing this health care disparity, the National Cancer Policy Forum of the Institute of Medicine convened a public workshop to examine the needs of AYA patients with cancer. Workshop participants identified many gaps and challenges in the care of AYA cancer patients and discussed potential strategies to address these needs. Suggestions included ways to improve access to care for AYAs, to deliver cancer care that better meets the medical and psychosocial needs of AYAs, to develop educational programs for providers who care for AYA cancer survivors, and to enhance the evidence base for AYAs with cancer by facilitating participation in research.

Filling the gap: development of the oncology nurse practitioner workforce.

A new strategy for oncology care delivery that includes increasing the numbers and expanding the roles of nonphysician practitioners is critically important to meet the current and potential cancer care needs of the US population.

Complexity Theory: A Long-Term Care Specialty Practice Exemplar for the Education of Advanced Practice Nurses

This clinical exemplar highlights how an academic clinical practice supported gerontological nursing students as they learned evidence-based approaches to managing complex geriatric syndromes in long-term care. Urinary incontinence (UI), which occurs in more than two thirds of nursing home residents, was the focus of the faculty practice. Advanced practice nursing skills developed by students included advanced physical assessment and diagnostic reasoning techniques, critical appraisal of the scientific evidence for UI management, and the ability to teach evidence-based approaches to UI care to bedside nursing staff. Outcomes of the practice for the facilities included improved detection of urinary retention, reduced wetness rates, and strengthened systems of care for UI. Student outcomes included an increased sense of self-efficacy in management of UI and other complex geriatric problems. Complexity theory guides a discussion of how curriculum design and research-based practices can be implemented to enhance both student and facility outcomes.

Reducing Tobacco-Related Cancer Incidence and Mortality: Summary of an Institute of Medicine Workshop

Tobacco use remains a serious and persistent national problem. Recognizing that progress in combating cancer will never be fully achieved without addressing the tobacco problem, the National Cancer Policy Forum of the Institute of Medicine convened a public workshop exploring current issues in tobacco control, tobacco cessation, and implications for cancer patients. Workshop participants discussed potential policy, outreach, and treatment strategies to reduce tobacco-related cancer incidence and mortality, and highlighted a number of potential high-value action items to improve tobacco control policy, research, and advocacy.

Partnerships of the Future

OBJECTIVES To explore how partnerships among private, nonprofit, and public organizations can be instrumental in addressing 21st century health care challenges. DATA SOURCES Peer-reviewed studies and guidelines, journal articles, books, websites, and personal communication. CONCLUSION Given the complexity of the health care environment and the need to transform the system, individuals and organizations will need to form partnerships that result in improved quality of care and decreased cost. Some recent initiatives have been successful and are included in this article. IMPLICATIONS FOR NURSING PRACTICE In many communities and at the national level, there are agencies and organizations that are working independently, yet they have overlapping goals and the same intent. They compete for the same financial and human resources whether in academia, the care delivery sector, or non-profit associations. In the cancer care world, interprofessional teams are essential, yet much care is still delivered in silos. There are redundant patient advocacy organizations even for some of the less common cancers. Partnerships and collaboration will take new forms and require new skill sets in the future.

Will They Come and Will They Stay

367 Deborah K. Mayer, PhD, RN, AOCN®, FAAN, is the editor of the Clinical Journal of Oncology Nursing and an associate professor in the School of Nursing at the University of North Carolina–Chapel Hill, and Brenda Nevidjon, RN, MSN, FAAN, is the president of the Oncology Nursing Society and a clinical professor in nursing and healthcare leadership in the School of Nursing at Duke University in Durham, NC.

Member Input: The Challenge of Staffing in Ambulatory Infusion Settings

&NA; The challenge of staffing in ambulatory infusion settings &NA; The Oncology Nursing Society (ONS) has conducted several member surveys that included questions about staffing but has not established nurse‐patient ratios, given the number and complexity of variables that must be considered. The 2016 ONS member survey showed that staffing was the most frequently cited challenge in the practice setting. With the implementation of ONS Communities in 2017, members have the opportunity to network and connect about issues. Staffing in chemotherapy infusion centers has been a frequent topic. AT A GLANCEWith the transition of treatments to the ambulatory setting, determining staffing has become a critical factor in developing ambulatory infusion and chemotherapy centers.Results from the 2016 ONS member survey indicated that appropriate staffing levels are a pressing challenge for ONS members in practice.To date, no standard staffing model or nurse‐patient ratio exist for ambulatory infusion and chemotherapy centers.

Oncology Nurses: Innovating Precision Care in a Changing Treatment Environment

Once a disease more prevalent in high‐income countries, cancer is now a global health concern due to the improved control of communicable diseases and greater knowledge about its genetic basis. The completion of the Human Genome Project in 2003 accelerated a focus on precision medicine adding molecular‐targeted therapies and immunotherapies to the traditional cancer treatments of surgery, radiation, and chemotherapy. The path to precision medicine has been longer than the completion of the Genome Project, however, as seen in Table 1. Oncology nurses are on the frontline of a rapidly changing cancer care environment with the implementation of precision medicine interventions. Understanding key concepts about cancer today and the advances in treatment that are underway prepares the oncology nurse to provide the appropriate care to patients as personalized care has always been the foundation of nursing.

Time can make a difference.

Through developing education, research, practice, and advocacy resources, the Oncology Nursing Society has supported and developed us as oncology nurses and as leaders.