Susan Bohnenkamp

Traditional versus telenursing outpatient management of patients with cancer with new ostomies.

PURPOSE/OBJECTIVES To measure the impact of telenursing on patients discharged with ostomies resulting from cancer treatment. DESIGN Quasi-experimental design with surveys. SETTING Large tertiary care center in the southwestern United States. SAMPLE 28 patients with cancer in two groups: traditional home health and home health plus telenursing. METHODS Recorded the number of home health and telenursing contacts, dates when ostomy self-care needs were met, supplies used, and distance traveled. Patients completed a satisfaction survey and Maklebusts Ostomy Adjustment Scale. MAIN RESEARCH VARIABLES Type of care, costs, patient satisfaction, ostomy adjustment, and time to achieve ostomy self-care. FINDINGS Telenursing patients indicated higher satisfaction. The home health group averaged one more home health visit per patient (telenursing mean= three visits). Overall costs for both types of visits were about equal. The home health group used an average of four more pouches per patient, with increased cost of 52 dollars per patient. Telenursing patients believed that nurses had increased understanding of their problems, and they were more comfortable with what nurses told them about ostomy. Telenursing participants believed that telenursing made care more accessible; they preferred telemedicine rather than waiting for face-to-face visits but still believed that face-to-face visits were best. CONCLUSIONS Combining traditional home health and telenursing is feasible for supporting discharged patients with new ostomies and enhances traditional home health, resulting in increased satisfaction overall. IMPLICATIONS FOR NURSING Oncology nurses should develop telenursing programs that include patient and family education regarding oncology issues.

Implementing Evidence-Based Practice Using an Interprofessional Team Approach: Part Two

The complexity inherent in the inpatient oncology population requires effective interprofessional collaboration and integrated evidence-based practice (EBP), drawing from each of the disciplines to achieve desired outcomes. Each member of the team lends a strength and expertise that, when combined, often results in outcomes greater than the sum of its parts (Hall & Weaver, 2001; Petri, 2010; Pullon & Fry, 2005). EBP promotes the use of research to solve issues raised in day-to-day nursing practice. This article provides an overview and summary of an evidence-based project to increase compliance of sequential compression devices (SCDs) in gynecologic oncology and urology patients on a post-surgical inpatient unit using the Plan, Do, Study, Act (PDSA) model for continuous quality improvement (CQI) (Institute for Innovation and Improvement, 2013).