Oncology Nurses Enhance Patient Experience through Navigators and Health Literacy

Rutgers Cancer Institute of New Jersey nurses present findings at national meeting
May 1, 2017

Nurse NavigatorNew Brunswick, N.J. – Navigating a treatment path for cancer can be challenging for many patients, especially coordination of appointments between multiple practitioners. Combine that with a wealth of information about the disease which may not be easy to understand and there exists the potential for poor health outcomes. Nurses at Rutgers Cancer Institute explored both topics in order to further enhance the patient experience. Their findings are being presented as part of a poster session at the Oncology Nursing Society’s Annual Congress being held this week in Denver, Colorado. 

Between 2014 and 2015, Rutgers Cancer Institute began to use patient navigators – one for the Hematologic Malignancies Program and the other for the Gynecologic Oncology Program. Navigators interact face to face with newly diagnosed cancer patients and help them facilitate communication between healthcare providers. They educate patients about their disease and treatment and identify and eliminate barriers to receiving therapy. Nurses assessed the impact of these navigators on both patient and provider satisfaction and access to care by measuring a decrease in length of time it takes for a patient to see an oncologist for an initial visit and time from first visit to start of treatment. Chart reviews, electronic medical records and surveys on provider and patient satisfaction were used. The data were compared to information available prior to the implementation of the navigators.

What they found was the use of nurse navigators led to positive outcomes including quicker access to care. They also found patients had a good relationship with their navigator and were highly satisfied with their care. Healthcare providers also expressed satisfaction.

 

Number of Participants

Interpersonal Relationships
(mean score out of 5)

Satisfaction with Patient Care
(mean score out of 5)

Provider Satisfaction
(mean score out of 5)

Gynecologic Oncology Patients

54

4.8

4.7

n/a

Hematologic Malignancies  Patients

47

4.9

4.8

n/a

Gynecology Providers

5

n/a

n/a

4.95

Hematologic Malignancies Providers

12

n/a

n/a

4.39

The authors note limitations to the research included a small sample size and the fact that the sample only included those from the Gynecologic Oncology Program and the Hematologic Malignancies Program.

“Patients often are the ones to coordinate their own care – working with numerous treatment providers to balance information, which sometimes can conflict. This can be challenging for a patient in making sound treatment decisions. Patient navigation has been used to help with this coordination, resulting in patient-centered care. It is encouraging to see this model expand in the cancer field,” notes Rutgers Cancer Institute Executive Director of Oncology Nursing Services Janet Gordils-Perez, DNP, RN, ANP-BC, AOCNP, who is the lead author of the work.

Other authors on the poster include Susan Schneider, PhD, AOCN, ACNS-BC, FAAN, Duke University School of Nursing; Molly Gabel, MD, Summit Medical Group; and Kathryn J. Trotter, DNP, CNM, FNPC, FAANP, Duke University School of Nursing.

Rutgers Cancer Institute nurses also examined patients’ ability to understand health information. “Those with poor health literacy also tend to have poor health and poor health outcomes,” notes Carla Schaefer, BSN, RN, OCN, associate director of infusion services at Rutgers Cancer Institute, who is the lead author of the poster addressing this topic. Nurses reviewed a new patient orientation class offered at Rutgers Cancer Institute over a six month period in 2016. Of 606 new patients identified, 70 percent registered for either the live class or an on-line version  that can be viewed from an off-site location.

Schaefer and colleagues learned that a majority of the attendees found the orientation to be the appropriate length, helpful and easy to understand. The nurses note that the number of patients who view the orientation remotely has not been captured and very few of those participants complete and return the survey.  “When a patient does not clearly understand their treatment plan, it can be challenging for that individual to be compliant with necessary medications and lifestyle changes. The risk for negative outcomes increases when information is not provided in a way that is easily understandable.  By assessing our new patient orientation program, we can ensure that patients are receiving the information they need at the appropriate comprehension level,” adds Schaefer. Other authors on the poster are Stephanie Frias, BSN-BC, RN, OCN, and Donna Thomas, BSN, RN, OCN, assistant nurse managers of infusion services at Rutgers Cancer Institute.

About Rutgers Cancer Institute of New Jersey
Rutgers Cancer Institute of New Jersey (www.cinj.org) is the state’s first and only National Cancer Institute-designated Comprehensive Cancer Center. As part of Rutgers, The State University of New Jersey, Rutgers Cancer Institute is dedicated to improving the detection, treatment and care of patients with cancer, and to serving as an education resource for cancer prevention both at its flagship New Brunswick location and at its Newark campus at Rutgers Cancer Institute of New Jersey at University Hospital. Physician-scientists across Rutgers Cancer Institute also engage in translational research, transforming their laboratory discoveries into clinical practice that supports patients on both campuses. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 848-932-8013 or visit www.cinj.org/giving. Follow us on Facebook at www.facebook.com/TheCINJ.

 

Contact: 
Michele Fisher
Phone: 
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