An Exploration of Nurse-led Models of Cancer Care in Ireland: A Mixed Method Study
Citation:PRABHUKELUSKAR, SNEHAL, An Exploration of Nurse-led Models of Cancer Care in Ireland: A Mixed Method Study, Trinity College Dublin.School of Nursing & Midwifery, 2020
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Background Within the cancer care services internationally and nationally, there has been a proliferation of nurse-led models of cancer care. However, such role development has all-too-often been ad hoc, and nature and duties undertaken vary considerably both within and across services. Aim The purpose of this study was to explore the current status of nurse-led models of cancer care in Ireland, and to provide a comprehensive understanding of the scope, governance and infrastructure underpinning nurse-led models of cancer care. Method: A sequential explanatory mixed method research design was used in this descriptive study. The first phase of the study involved a national quantitative survey of nurses interested in cancer care. This was followed by qualitative interviews with a sample of 11 volunteers from phase I of the study to explore nurses' perceptions of the benefits and impacts of nurse-led models of care, as well as the challenges and barriers for implementing these models of cancer care. Ethics approval was obtained prior to the study. Results A total of 217 questionnaires were distributed to all members of the IANO, and a total of 87 completed questionnaires were returned, representing a response rate of 40%. The main motives behind the development of nurse-led models of cancer care is to facilitate increased clinical demand, reduce waiting time, ease pressure on clinical service, extend doctors' capacity, and utilize specialist nursing roles to maximise quality of care for cancer patients. It is clear from the findings that the developments of nurse-led models of cancer is at an early developmental stage in Ireland. There is a wide variety of nurse-led services namely symptom management, treatment, and follow-up care. There is a wide variation in description with regards to nurses, including their grade, qualification, experience, and role description, suggesting different levels of autonomy and clinical practice. Nurses are facing various challenges and barriers in the development and successful implementation of nurse-led models of cancer care such as lack of provision for of cover for staff absence, lack of administrative support and poor structural planning prior to developing the nurse-led service. Explanations offered not being able to provide an equivalent service was the lack of appropriate trained nurses to provide cover. Nurses also reported a lack of support from hospital management, including nursing management. Nurses perceive the reason for this lack of support to be a lack of understanding of the nurse-led service. Nurses are seeking a structural pathway for the development and implementation of nurse-led models of cancer care. Conclusion Nurse-led models of cancer care are indeed an innovative approach to cancer care delivery, providing benefits to the service provider, as well as to the service user. More structured planning and objective evaluation of service needs, and active endorsement and participation from support staff, is required for the successful implementation and sustainability of these models of care. The introduction of a national framework with national guidelines for role descriptions, training, resource planning and evaluation of nurse-led models of cancer care will provide more transparency for nurses and other health care professionals.
Author: PRABHUKELUSKAR, SNEHAL
Publisher:Trinity College Dublin. School of Nursing & Midwifery. Discipline of Nursing
Type of material:Thesis
Availability:Full text available