Oncology Nursing Society Members Research Articles

Preparing Nurses for Governance of Professional Nursing Organizations: Evaluation of an E-Learning Approach

A descriptive survey project was conducted with the Oncology Nursing Society to determine how professional nursing organizations prepare their nurse members for board roles and evaluate how well prepared Oncology Nursing Society members were to serve on a professional board of directors after completing a board governance e-learning program. While the findings revealed some encouraging results, opportunities exist for professional nursing organizations to prepare nurses for board governance roles and for nurses to gain additional confidence in leading boards. Recommendations based on these results will help leadership development committees refine their strategies for building future leaders.

Palliative Care: Oncology Nurses' Confidence in Provision to Patients With Cancer.

Oncology nurses are key providers of care to patients with cancer in all healthcare settings. However, little is known about oncology nurses' perceived confidence in providing all of the domains of palliative care. The objectives of this study were to examine oncology nurses' perceived confidence in providing palliative care to patients with cancer and to identify the association between nurses' demographic and professional characteristics and their perceived confidence. A descriptive correlational design was employed. The sample included RNs who provided care to patients with cancer and were members of the Oncology Nursing Society (ONS). Participants completed an online survey consisting of 14 demographic questions and a 50-item palliative care confidence scale. Three hundred sixty-six ONS members completed the survey. Results showed that most oncology nurses were confident to very confident in providing palliative care to patients with cancer, but they lacked confidence in providing the psychosocial, spiritual, and legal and ethical aspects of care. Years of experience as an oncology nurse and palliative care training were significantly associated with perceived confidence in providing palliative care.

Oncology Nurses' Knowledge, Confidence, and Practice in Addressing Caregiver Strain and Burden

To describe nurses' practices, confidence, and knowledge of evidence-based interventions for cancer caregiver strain and burden and to identify factors that contribute to these aspects. . 2,055 Oncology Nursing Society members completed an emailed survey. . Pooled analysis of survey results. Variables included the baseline nursing assessment, intervention, confidence, knowledge, strategies used, and barriers encountered. . Nurses tend to overestimate the strength of evidence for interventions not shown to be effective and have moderate confidence in assessing and intervening with caregivers. Having been an informal caregiver and having received care from an informal caregiver were associated with higher reported practice and confidence. Major strategies used were referral to social workers and others. Barriers reported were financial, caregiver emotional responses, and distance. . An opportunity exists to increase nurses' knowledge and confidence in assessment and intervention with caregivers. Greater use of technology may help nurses overcome some barriers to working with caregivers. Findings can be used to plan continuing education, develop clinical processes, and identify resources nurses need to address strain and burden among informal caregivers.

Personal Protective Equipment Use and Hazardous Drug Spills Among Ambulatory Oncology Nurses

To examine patterns and organizational correlates of personal protective equipment (PPE) use and hazardous drug spills. Cross-sectional mailed survey. Ambulatory practices in California, Georgia, and Michigan. 252 Oncology Nursing Society members who administer hazardous drugs. Bivariate and multivariable regression analyses. Outcomes were PPE use and hazardous drug spills. Covariates included nursing workloads, nurses’ practice environments, and barriers to PPE use. Twenty-six percent reported a recent drug spill, and 90% wore only one pair of chemotherapy-tested gloves. Increased PPE use was associated with increased nurse participation in practice affairs, nonprivate ownership, increased nursing workloads, and fewer barriers to PPE use. Spills were associated with significantly less favorable manager leadership and support and higher workloads. Drug spills occur often in ambulatory settings. PPE use remains low, and barriers to PPE use persist. Higher workloads are associated with more drug spills. Managers should monitor and correct aberrant workloads and ensure that PPE is available and that staff are trained.

Transitioning Between Editors: Describing the Process

Transitioning Between Editors: Describing the Process

Voices of Oncology Nursing Society members matter in advocacy and decisions related to U.S. Health Policy

The Oncology Nursing Society (ONS), a member of the Nursing Organizations Alliance, invests in advocating for health and public policy decisions by sending members to the Nurse in Washington Internship (NIWI) program annually. NIWI provides a forum to educate nurses on the legislative process, giving attendees a better understanding of political, legislative, and regulatory issues facing nurses. The 2014 ONS delegation participated in training and lobbying focused on federal funding issues, nursing education, workforce oversight, and funding for nursing research. The three-day program ended with a Capitol Hill visit where nurses met with their respective legislators or their staff, using skills learned at NIWI briefings to influence policy for nurses and the patients they serve. Critical health and public policy decisions affecting nurses, their practice, and their patients require participation in and understanding of the legislative process. This article provides a glimpse into the three-day experience of the delegates attending the 2014 NIWI.

Priorities for oncology nursing research: the 2013 national survey.

To advance the goals of evidence-based care and prioritize the knowledge generation that addresses contemporary challenges in oncology nursing. Results are used to inform the development of the Oncology Nursing Society (ONS) Research Agenda and by the ONS Foundation to develop strategic research initiatives. Descriptive, cross-sectional survey. Web-based survey. 8,554 ONS members from all levels of education. All doctorally prepared members were invited to participate. A random stratified sample was obtained from the remainder of the membership. The ONS Research Priorities Survey project team created the survey and analyzed and interpreted the results. Members received an email invitation and follow-up reminders for survey completion. Oncology nursing research and evidence-based practice topic questions. The response rate was 11%, which is comparable to previous surveys. Topics ranked included descriptive research on patient adherence; intervention studies to optimize adherence, achieve concordance with cancer screening guidelines in minority populations, manage neurologic and cardiovascular late effects, and manage symptoms and symptom clusters; and studies to identify optimal delivery models for survivorship care. These findings have direct implications for translating existing evidence into practice and underscore the need for intervention research focused on improving patient-centered outcomes. Results provide a broad assessment of member views regarding oncology research priorities. Given the response rate, additional strategies to encourage member participation will be considered. The results, together with the updates of the ONS Research Agenda, can guide ONS and ONS Foundation research and evidence-based practice initiatives.

Revisions to the 2009 American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards: Expanding the Scope to Include Inpatient Settings

In November 2009, the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS) jointly published a set of 31 voluntary chemotherapy safety standards for adult patients with cancer, as the end result of a highly structured, multistakeholder process. The standards were explicitly created to address patient safety in the administration of parenteral and oral chemotherapeutic agents in outpatient oncology settings. In January 2011, a workgroup consisting of ASCO and ONS members was convened to review feedback received since publication of the standards, to address interim changes in practice, and to modify the standards as needed. The most significant change to the standards is to extend their scope to the inpatient setting. This change reflects the conviction that the same standards for chemotherapy administration safety should apply in all settings. The proposed set of standards has been approved by the Board of Directors for both ASCO and ONS and has been posted for public comment. Comments were used as the basis for final editing of the revised standards. The workgroup recognizes that the safety of oral chemotherapy usage, nononcology medication reconciliation, and home chemotherapy administration are not adequately addressed in the original or revised standards. A separate process, cosponsored by ASCO and ONS, will address the development of safety standards for these areas.

Revisions to the 2009 american society of clinical oncology/oncology nursing society chemotherapy administration safety standards: expanding the scope to include inpatient settings.

In November 2009, ASCO and the Oncology Nursing Society (ONS) jointly published a set of 31 voluntary chemotherapy safety standards for adult patients with cancer, as the end result of a highly structured, multistakeholder process. The standards were explicitly created to address patient safety in the administration of parenteral and oral chemotherapeutic agents in outpatient oncology settings. In January 2011, a workgroup consisting of ASCO and ONS members was convened to review feedback received since publication of the standards, to address interim changes in practice, and to modify the standards as needed. The most significant change to the standards is to extend their scope to the inpatient setting. This change reflects the conviction that the same standards for chemotherapy administration safety should apply in all settings. The proposed set of standards has been approved by the Board of Directors for both ASCO and ONS and has been posted for public comment. Comments were used as the basis for final editing of the revised standards. The workgroup recognizes that the safety of oral chemotherapy usage, nononcology medication reconciliation, and home chemotherapy administration are not adequately addressed in the original or revised standards. A separate process, cosponsored by ASCO and ONS, will address the development of safety standards for these areas.

Measuring Oncology Nurses' Psychosocial Care Practices and Needs: Results of an Oncology Nursing Society Psychosocial Survey

To develop and implement a survey of Oncology Nursing Society (ONS) members focused on their current practices and needs in relation to providing psychosocial care. Descriptive, cross-sectional. Web-based survey of ONS members. An invitation was e-mailed to 11,171 ONS members. Of those, 623 followed the link to the electronic survey and 64% of those (n = 401) completed the survey. An ONS Psychosocial Project Team was convened in 2009. One of the team's goals was to develop a survey to assess members' needs. The final survey consisted of 24 items, including five items related to demographic characteristics. Response formats included Likert-type scale, yes and no, and open-ended questions. Psychosocial care practices, education, and research. Psychosocial concerns are assessed using a variety of methods. Nurse perceptions regarding primary responsibility for providing psychosocial services differ by group. Barriers to the provision of psychosocial care exist at the individual, institutional, and community levels. Although nurses assess patients' psychosocial needs, multiple barriers still exist related to interdisciplinary communication; knowledge of the Institute of Medicine's recommendations; and resources at the individual, institutional, and community levels. The survey results were presented to the ONS Board of Directors, along with a three-year plan that included recommendations for future development of advocacy, practice, education, and research initiatives. Additional work is needed to effectively support RNs in their provision of psychosocial care to patients and families.

Oncology Nurses' Attitudes Toward Prognosis-Related Communication: A Pilot Mailed Survey of Oncology Nursing Society Members

To assess oncology nurses' attitudes toward prognosis-related communication and experiences of the quality of such communication among physicians. Cross-sectional study. Nationwide survey in the United States. 394 Oncology Nursing Society members who completed surveys. Pilot mailed survey. Demographic variables, measures of attitudes toward and experiences of prognosis-related communication. Nurses had mixed views of prognosis-related communication and identified common barriers to their own more effective participation in prognosis-related communication. Nurses with more experience and those who worked in inpatient settings were more likely to be present for physicians' prognosis-related communication with patients. Respondents identified uncertainties regarding the scope of oncology nurses' role in prognosis-related communication. Respondents also identified opportunities for improved interdisciplinary communication, most importantly the inclusion of oncology nurses in prognosis-related communication. Opportunities for oncology nurses to bridge some gaps in prognosis-related communication likely exist, although barriers surrounding nurses' role, education, and communication within the context of the larger healthcare team need to be clarified if potential solutions are to be developed.

Oncology Nurses' Perspectives on the State of Cancer Survivorship Care: Current Practice and Barriers to Implementation

to describe current survivorship care from the perspectives of oncology nurses. descriptive. e-mail invitation to Web-based survey. 399 Oncology Nursing Society members providing care for patients initially treated more than one year previously. an online survey was used to evaluate current aspects of survivorship care. practice settings, services provided, and barriers to delivering survivorship care. few nurses (27%) worked in settings with a formal survivorship program. Several program components were provided significantly more often in outpatient settings, pediatric facilities, and workplaces with a formal survivorship program. At the transition from acute to follow-up care, the survivorship nursing care provided most often was scheduling for ongoing monitoring (71%) and the least likely was assistance for employment or legal issues (16%). The greatest barriers to providing survivorship care were lack of time and funding (46%). Among nurses new to oncology (fewer than five years), 49% indicated they lacked sufficient knowledge compared to 36% of nurses with more than five years of oncology experience. findings describe current aspects of survivorship care across practice settings. Nurses reported that the greatest barriers are lack of time, funding, and lack of knowledge about survivorship issues. a need exists for education to enhance knowledge and skills of nurses who will provide survivorship care. Research is warranted to develop empirically supported guidelines and care-delivery models that address the barriers to providing survivorship services.

Oncology Nurses' Use of National Comprehensive Cancer Network Clinical Practice Guidelines for Chemotherapy-Induced and Febrile Neutropenia

To describe oncology nurses' use of National Comprehensive Cancer Network (NCCN) clinical practice guidelines for chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN). Cross-sectional survey design; descriptive, correlational analysis. E-mail invitation to Web-based survey. Random sample of 309 Oncology Nursing Society (ONS) members with e-mail addresses who provide care to adult patients receiving chemotherapy. The investigator-developed Neutropenia Oncology Nurses Survey was used. Descriptive tests compared respondents' personal and professional characteristics to those of general ONS members; nonparametric chi-square and Kruskal-Wallis tests were used to correlate respondents' survey subscale scores with demographic data. Significant associations were entered into multiple logistic regression models. The Neutropenia Oncology Nurses Survey's subscales measured subjective norm, attitude, perceived competence and confidence, perceived barriers, and use of NCCN clinical practice guidelines for CIN and FN. Response rate of nurses who opened the survey was 50%. Most practiced in community versus academic centers. Eighty percent reported using the NCCN clinical practice guidelines for CIN and FN. Respondents were more likely to use clinical practice guidelines when they were expected to by physician and nurse colleagues, they perceived fewer barriers, or they held advanced oncology certification. This study was the first to assess oncology nurses' reported use of NCCN clinical practice guidelines for CIN and FN. It also demonstrated the feasibility of partnering with ONS for Web-based survey research. The findings give insight into work-place barriers to evidence-based practice in various settings. Expanding dissemination and implementation of clinical practice guideline recommendations will support the development of oncology nursing standards for risk assessment, management, and patient and family education in CIN and FN.

Oncology societies focus on improving geriatric oncology education

For the first time at its annualmeeting this year, ASCO sponsored a geriatric oncology forum that was open to its general membership rather than to a small, invitation-only audience. A standingroom-only crowd of 180 attended “Designing Clinical Trials for Older Patients: Laboratory Science and Practical Applications.” “Obviously, we'll need a bigger roomnext year,” says Marilyn Raymond, ASCO's director of professional development. As interest in this burgeoning field continues to increase, oncology leaders are working to develop new tools to help providers improve their care to this growing population. This past summer, ASCO introduced a core curriculum for geriatric oncology on its ASCO Universitywebsite (available at: http://university.asco.org). The module, which offers Continuing Medical Education credit, includes 4 presentations on the topics of “Aging andCancer,” “Physiology of Aging,” “Assessment of the Older Cancer Patient,” and “Pharmacology and Aging.” The website also includes training modules that focus specifically on both breast cancer and prostate cancer in older patients. Additional disease-specific modules are expected to launch within a year. Meanwhile, the Oncology Nursing Society (ONS) has been developing a special geriatric training program for its members. Its goal is to make the program available by the end of 2010. It will include an online course that will prepare trainers to deliver a Power Point curriculum to bedside clinicians in a variety of settings, including nursing homes and hospitals. “I see a need for it in every area that I touch,” says Mary Kate Eanniello, who runs the nurse educator cancer program at Hartford Hospital in Hartford, Connecticut. The idea for the training program spun out of a meeting with the Hartford Institute for Geriatric Nursing at New York University College of Nursing in New York City, during which ONS members were asked to determine what they could do to support geriatric education through their specialty. “Oncology nurses look holistically at patients and are very interested in quality of life,” Eanniello says. “They are hungry for information about how to treat these patients differently and to give bedside care that will improve their quality of life.” Because older patients often have other physical problems and fewer reserves and because they may react differently from younger adults to various medications, nurses often must spend more time with them, she adds. “It's exciting to see ONS focused on infusing this into their organization,” Eanniello says. “You're kidding yourself if you don't think you need added knowledge about this population. I don't think there are many people who wouldn't benefit from hearing this content.”

Oncology Nurses' Perceptions of Obstacles and Supportive Behaviors at the End of Life

To determine the magnitude of selected obstacles and supportive behaviors in providing end-of-life (EOL) care to patients with cancer as perceived by oncology nurses. Cross-sectional survey. National survey sample. A geographically dispersed national random sample of 1,000 Oncology Nursing Society members who had cared for inpatient patients with cancer, could read English, and had experience in EOL care. Eligible respondents received a 68-item questionnaire in the mail adapted from previous studies and were asked to rate the size of obstacles and supportive behavior items in caring for patients with cancer at the EOL. EOL, oncology, barriers, supportive behaviors, oncology nurses, and survey research. Returns after three mailings yielded 375 usable questionnaires from 907 eligible respondents for a return rate of 41%. The items with the highest perceived obstacle magnitude were (a) dealing with angry family members, (b) families not accepting what they are told about patients' poor prognosis, and (c) nurses being called away from dying patients to care for other patients. The three-highest scoring supportive behaviors were (a) allowing family members adequate time alone with patients after they died, (b) having social work or palliative care staff as part of the patient care team, and (c) having family members accept that patients are dying. EOL care can be improved by working to decrease the highest-rated barriers and by continuing to support the highest-rated supportive behaviors. Oncology nurses are dedicated, experienced, and comfortable handling most issues in EOL care. Recommendations to support oncology nurses include strategies to interact effectively with angry, anxious, or overly optimistic family members as well as involving social work and palliative care staff on the oncology interdisciplinary team. In addition, the information regarding identified obstacles and supportive behaviors in oncology EOL care can be used to facilitate discussion and change within oncology interdisciplinary teams and improve EOL care for patients with cancer and their families.

Oncology nurses’ views of oncologists’ prognosis-related communication (PRC)

6602 Background: PRC is critical to care, treatment, and decision-making for advanced cancer patients (ACP). Deficits in oncologists’ (MDs) PRC have previously been identified. The role oncology nurses (RNs) play in PRC and their views and experiences of PRC among MDs with whom they work is unknown. Methods: Mail survey of a random sample of Oncology Nursing Society members with at least one year of experience working with cancer patients (pts). Questionnaire was sent to 1338 members of ONS. 394 completed surveys were returned. Overall RR was 29.4%. Significance, if noted, implies p<0.001. Results: Respondent demographics: median age 49.2, 96.6% female, 88.5% Caucasian, median years (yrs) as an RN 18, median yrs working with cancer patients 12, 69.1% had a BSN or ASN, 34.1% inpt RNs, 38.6% outpt RNs. 46% of RNs always/often cared for ACPs who did not appear to understand their prognosis, and 58.6% of RNs always/often encountered questions that suggested pts wanted more prognosis related information (PRI). 26.1% disagreed that the MDs they worked with were skilled at PRC. 72% agreed that MD discomfort with giving bad news is a major barrier to helping pts understand their prognosis. 54.9% of RNs always/often/sometimes felt pressured not to provide pts PRI because they did not want to contradict what MDs had said. 25.1% of RNs felt that MDs rarely or never kept them informed about their PRC with pts (frequency positively associated with yrs as an RN, yrs working with cancer pts, education level). RNs with at least an MSN were more likely to report that MDs more frequently kept them informed about their PRC. 30.2% of RNs felt that MDs rarely or never addressed end of life issues early in the course of their illness. 32.8% of RNs agreed that, when pts did not appear to understand their prognosis, it was because MDs had not discussed it fully (positively associated with working in an inpt setting). 42.6% of RNs were rarely or never present when PRI was discussed (negatively associated with working in an outpt setting and amount of formal education regarding PRC). Conclusions: Oncology RNs identify several deficits in MDs’ PRC with ACPs, including provision of information early in the course of illness, gaps in sharing content of PRC with RNs, and communicative aspects of team-based pt care. No significant financial relationships to disclose.

Complementary and Alternative Medicine: Oncology Nurses' Knowledge and Attitudes

To describe oncology nurses' complementary and alternative medicine (CAM) knowledge and attitudes. Descriptive, cross-sectional. A national medical center and research institute. A random sample of 850 Oncology Nursing Society members who are RNs involved in direct care. Respondents completed a demographic questionnaire and the Nurse Complementary and Alternative Medicine Knowledge and Attitude survey. Descriptive analysis was used to describe the participants' CAM knowledge and attitudes. In addition, participants' comments were transcribed and content analysis was conducted. CAM knowledge and attitudes. The participants' mean CAM knowledge score was 70%. Attitudes varied according to beliefs, practice, and role, but were positive overall. Assessing oncology nurses' CAM knowledge is important for developing appropriate educational programs that will help nurses support and advocate for patients. In addition, assessing CAM attitudes will provide insight for realizing and sustaining robust changes to health care. Oncology nurses should be prepared with insightful CAM knowledge and attitudes to provide prudent and unbiased information to patients.

2008 ONS Research Priorities Survey

To determine the priorities of oncology nursing research, including the effect of evidence-based practice resources as identified by the Oncology Nursing Society (ONS) membership in June 2008. Descriptive, cross-sectional. A Web-based survey of ONS members. Stratified into three groups: a representative random sample of the general membership (n = 4,460, 421 responded), an over-sampled random sample of advanced practice nurses (n = 980, 149 responded), and all ONS members who were doctorally prepared (n = 589, 143 responded); 713 responded overall. The 2004 survey was revised and the new 2008 survey was beta tested. The invitation to complete the survey was sent via e-mail with a link to the survey Web site. A follow-up reminder was sent one week after the initial invitation. 70 oncology nursing research topic questions, divided into five categories, and two additional categories regarding ONS Putting Evidence Into Practice resources. Quality of life and pain were the two highest rated topics, consistent with 2000 and 2004 research priority survey findings. Eleven topics were new to the top 20 ranked priority topics in 2008. Differences in rankings were apparent between member groups. The respondents represented the broad spectrum of ONS membership. Changes in topic rankings indicate that oncology nursing research priorities have shifted since the 2004 survey. The lag in research result dissemination to clinical practice may account for differences in topic rating between groups. The survey results will be used to develop the 2009-2013 ONS Research Agenda. The results also will assist the ONS Foundation and other funding agencies in setting priorities.

Learning from the Experts: Oncology Nursing Society Members as Educators

There is no abstract for this article.

Oncology End-of-Life Nursing Education Consortium Training Program: Improving Palliative Care in Cancer

To describe an evaluation of the oncology version of the End-of-Life Nursing Education Consortium (ELNEC-Oncology) training program, which is designed to provide oncology nurses with the knowledge and materials necessary to disseminate palliative care information to their colleagues in local chapters of the Oncology Nursing Society (ONS). Participant reports. 124 nurses representing 74 ONS chapters attended the first two courses. Dyads of ONS members from local chapters applied to attend ELNEC and completed surveys regarding their goals and expectations for implementing end-of-life (EOL) education and training after completion of the program. Participants educated more than 26,000 nurses after attending the program, including 7,593 nurses within their ONS chapters and 18,517 colleagues within their workplaces. Barriers to implementation included a lack of funding and time constraints. Participants sought additional palliative care learning opportunities, including attending other workshops, subscribing to palliative care journals, and becoming involved in committees focused on palliative care. The ELNEC-Oncology program is a national collaboration with ONS that provides oncology nurses with the tools and expertise to effectively disseminate palliative care content to colleagues within their local chapters and work settings. EOL care information remains critical to the science of oncology nursing, and ELNEC-Oncology provides an effective strategy for disseminating the information.