Stewart, I., Leary, A., Tod, A. orcid.org/0000-0001-6336-3747 et al. (5 more authors) (2018) Barriers to delivering advanced cancer nursing : a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit. European Journal of Oncology Nursing, 36. pp. 103-111. ISSN 1462-3889
Abstract
Purpose
Health services across the world utilise advanced practice in cancer care. In the UK, lung cancer nurse specialists (LCNS) are recognised as key components of quality care in national guidelines, yet access to LCNS contact is unequal and some responsibilities are reportedly left undone. We assess whether any variation in working practices of LCNS is attributable to factors of the lung cancer service at the hospital trust.
Method
Nationwide workload analysis of LCNS working practices in England, linked at trust level to patient data from the National Lung Cancer Audit. Chi-squared tests were performed to assess whether patient contact, workload, involvement in multidisciplinary teams (MDT), and provision of key interventions were related to 1) the trust's lung cancer service size, 2) LCNS caseload, 3) anti-cancer treatment facilities and 4) lung cancer patient survival.
Results
Unpaid overtime was substantial for over 60% of nurses and not associated with particular service factors assessed; lack of administrative support was associated with large caseloads and chemotherapy facilities. LCNS at trusts with no specialty were more likely to challenge all MDT members (80%) compared with those at surgical (53%) or chemotherapy (58%) trusts. The most frequent specialist nursing intervention to not be routinely offered was proactive case management.
Conclusion
Working practices of LCNS vary according to service factors, most frequently associated with trust anti-cancer treatment facilities. High workload pressures and limited ability to provide key interventions should be addressed across all services to ensure patients have access to recommended standards of care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018 Elsevier. |
Keywords: | Case management; Clinical audit; Lung neoplasms; Nurse specialists; Survey; Workload |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 20 Aug 2019 11:36 |
Last Modified: | 20 Aug 2019 11:36 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1016/j.ejon.2018.07.006 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:149794 |