Perceived factors influencing nurses' use of evidence-informed protocols for remote cancer treatment-related symptom management: A mixed methods study. Issue 3 (June 2015)

• Record Type: Journal Article
• Authors: Stacey, Dawn; Carley, Meg; Ballantyne, Barbara; Skrutkowski, Myriam; Whynot, Angela; Pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) Team
• Is Part Of: European journal of oncology nursing. Volume 19:Issue 3(2015:Jun.)
• Page Start: 268
• Page End: 277
• Publication Date: 2015-06
• Subjects: Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2014.11.002
• Languages: English
• ISSNs: 1462-3889

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Purpose</title> <p id="abspara0010">To assess factors perceived to influence nurses' use of symptom protocols when providing remote management for oncology patients.</p> </sec> <sec> <title id="sectitle0020">Method</title> <p id="abspara0015">A mixed methods descriptive study was guided by the Knowledge-to-Action Framework. In 2013, 8 focus groups and 7 interviews were conducted with 49 nurses or patients/family members in three ambulatory oncology programs within different provincial healthcare systems. Role-play with a protocol was used during nurse focus groups/interviews. Nurses who provided remote symptom support received a survey. Data was triangulated using thematic analysis guided by the Ottawa Model of Research Use.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Over 90% of nurses provide telephone support during regular hours only. These symptom protocols were being used by 14% of nurses at one program. Nurses rated the protocols positively for content and format (>85%) but 20% indicated too complex. Protocol facilitators were systematic approach, comprehensive, and evidence-based. Protocol barriers were too long, not for symptom clusters, and inadequate space for documenting. To facilitate use, nurses need to enhance their knowledge (73%) and skills (58%), get access to resources, and obtain performance feedback. Nurse barriers included the learning curve, being unaware of protocols, and feeling tied to a script. Organizational barriers were communication challenges with patients, lack of electronic charting, and no clear direction to use them (54%).</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Several barriers and facilitators were perceived to influence the use of symptom protocols. Nurses and patients/family members identified similar factors. Interventions are needed to overcome barriers to nurses using the protocols such as education, clear organizational mandate, and integration with documentation.</p> </sec> </abstract>