At the second annual Oncology Nurse Advisor Navigation Summit (April 7-9, 2016; Orlando, FL), Teresa Labovich, MSN, RN, OCN, Penrose Cancer Center (Colorado Springs, CO), described a method by which gastrointestinal (GI) oncology nurse navigators (ONN) can play a role in improving institutional efficiency and patient outcomes.
The concept of nurse navigation was conceived of in 1990, but it has been slow to disseminate to different oncology specialties. However, at Penrose Cancer Center, navigators have been implemented in a number of different cancer types, including blood, prostate, and breast cancers.
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In her presentation, Ms Labovich described how she improved the outcomes of patients with varying forms of GI cancer with the help of a multidisciplinary care team. She and the team started by reviewing guidelines developed by the National Comprehensive Cancer Network (NCCN) along with other key quality measures based on evidence and national standards. They then used that review to identify ways in which they could improve processes at Penrose for patients and providers.
Interventions were aimed primarily at identifying patients with high-output stoma (HOS), improving care for those patients, correcting fluid and electrolyte disturbances, and optimizing the nutritional status of these patients.
To improve the quality of care for these patients, Ms Labovich said that the GI ONN must be actively involved in managing communications between physicians and other stakeholders involved in patient care, tracking pathology reports, and coordinating follow-up care and tests. At Penrose, these data were reviewed quarterly at GI multidisciplinary committee meetings.
At 3 years, Ms Labovich reported that patient outcomes and adherence to NCCN guidelines both improved. Most notably, screening for Lynch Syndrome grew to a rate of 94% and postoperative readmissions and emergency department visits fell by 13% among patients with ileostomies.
With the help of an outpatient oncology dietitian, Ms Labovich also created a process for consistent assessment, documentation, and implementation of pancreatic enzyme therapy for patients with insufficiencies.
Ms Labovich finished by stating that they were able to accomplish their goals through targeted GI ONN interventions facilitated by multidisciplinary care team members.
