Optimizing the Radiation Oncology Nursing Care Model Within an Academic Practice Setting

Abstract

<h3>Purpose/Objective(s)</h3> Registered nurses (RN) can provide patients with the necessary support to successfully complete radiation treatment, including coordination of care, education, and toxicity management. Optimal nursing support can also improve the efficiency of the provider. Within an academic radiation oncology facility, we found that RNs were underutilized, performing mainly secretarial or medical assistant level tasks. The purpose of this study was to identify opportunities for process improvement in the nursing care model with the intent to improve nursing job satisfaction, provider satisfaction and patient satisfaction. <h3>Materials/Methods</h3> A job satisfaction survey was designed to determine RN satisfaction with the tasks that they are assigned and their overall satisfaction of their job duties. A provider satisfaction survey was designed for physicians and nurse practitioners to determine their satisfaction in providing high quality care for their patients. Surveys were sent to the nursing and provider teams in August 2020, to determine initial state and 6 months later in February 2021. Survey data was collected anonymously. In the 6 months between surveys, the RN teams began formal clinic prep, to understand and prepare for new patients/follow up patients for the week and catch any issues that would cause delays during the patient visit, RNs were encouraged to attend the new patient consultation visits to anticipate care coordination issues, and RNs were encouraged to be proactive in answering portal messages from patients rather than sending them directly to the provider. <h3>Results</h3> The nursing survey was a 5-point rating scale (1 worst-5 best): job duties match knowledge and skills: 3.8, job responsibilities match strengths: 3.2, ability to advocate for patients: 4.4, providers communicate well: 3.0, nursing staff works as a team: 3.4 and enjoy working in this department: 4.3. At 6 months follow up, job duties match knowledge and skills: 4.2, job responsibilities match strengths: 4.3, ability to advocate for patients: 4.6, providers communicate well: 3.5, nursing staff works as a team: 3.9 and enjoy working in this department: 4.5. The provider survey consisted of the following: 67% of providers knew who their primary nurse was, 100% understood the nurse's primary responsibilities, ability to advocate for your patients scored 4.2/5, 56% felt like they had appropriate nursing support, and nurses communicate well scored 3.1/5. At 6 months follow up, 88% of providers knew who their primary nurse was, ability to advocate for your patients scored 4.6/5, appropriate nursing support 4.0/5, and nurses communicate well 4.1/5 <h3>Conclusion</h3> Optimizing nursing care delivery within the academic practice setting is feasible and led to improved nurse and provider satisfaction. The interventions studied here are low in cost and easily implemented. This work is ongoing to further improve the nursing care model in radiation oncology clinics.