Measuring the Impact of Academic Cancer Network Development on Clinical Integration, Quality of Care, and Patient Satisfaction.

Purpose: Many US academic centers have acquired community practices to expand their clinical care and research footprint. The objective of this assessment was to determine whether the acquisition and integration of community oncology practices by Yale/Smilow Cancer Hospital improved outcomes in quality of care, disease team integration, clinical trial accrual, and patient satisfaction at network practice sites.

Methods: We evaluated quality of care by testing the hypothesis that core Quality Oncology Practice Initiative measures at network sites that were acquired in 2012 were significantly different after their 2016 integration into the network.

Perceptions of roles, practice patterns, and professional growth opportunities: broadening the scope of advanced practice in oncology.

Broadening the scope of advanced practice providers (APPs) has been offered as a solution to increasing healthcare costs, workforce shortage, and increased demand. To understand present scope and barriers to broadening it, the authors describe the perceptions and practice patterns of APPs. This cross-sectional study used a computerized self-report survey of 32 targeted nurse practitioners and physician assistants employed in the cancer center of an urban teaching hospital; 31 were included in the quantitative analyses.

Transition to a new cancer care delivery system: opportunity for empowerment of the role of the advanced practice provider.

The purpose of the study was to obtain an in-depth understanding of the perceptions of advanced practice providers (APPs) with respect to their current roles in the context of the transition to a new cancer care delivery system, as well as factors that may influence their ability to practice at their level of training and education. Five focus groups were conducted with 15 APPs (11 nurse practitioners, 4 physician assistants). Data were collected by a recorder at each focus group.

The EDUCATE Study: a continuing education exemplar for Clinical Practice Guideline Implementation.

Cancer care is evolving from a solo practitioner care delivery system based on tradition and anecdotal experience to a multidisciplinary, collaborative, science-driven paradigm. Evidence-based practice facilitates optimal care quality for patients with cancer and is effected for medical and nursing practitioners through clinical practice guideline implementation. Clinician education based on principles of adult learning is one method of implementing clinical practice guidelines in clinical practice.

Cancers of the pancreas and hepatobiliary system.

Objectives: To review the incidence, risk factors, staging, and diagnosis of hepatobiliary malignancies and pancreas cancer as well as nursing challenges associated with managing patients with these tumors.

Data Sources: Published research reports, epidemiologic data, patient management guidelines, and institution-based clinical tools.

Conclusion: While survival is slowly increasing, morbidity and mortality associated with hepatobiliary and pancreas cancers remains high.

Vesicant extravasation part II: Evidence-based management and continuing controversies.

Purpose/objectives: To review the literature, synthesize current recommendations, and discuss remaining controversies regarding vesicant extravasation management.

Data Sources: Published evidence-based reports, clinical articles, and anecdotal case reports about antineoplastic and nonantineoplastic vesicant agent management.

Data Synthesis: Prevention of vesicant extravasation sequelae requires knowledge about vesicant extravasation manifestations and differentiation of vesicant extravasation from other local IV site reactions.

Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk.

Purpose/objectives: To review the literature regarding the incidence, current practice, guideline recommendations, nursing management, and knowledge gaps relevant to vesicant extravasation.

Data Sources: Published research articles, books, case reports, and national guidelines.

Data Synthesis: Vesicant extravasation is a relatively rare but significant complication of chemotherapy administration.

Recommended guidelines for the treatment of cancer treatment-induced diarrhea.

Purpose: To update and expand on previously published clinical practice guidelines for the treatment of cancer treatment-induced diarrhea.

Methods: An expert multidisciplinary panel was convened to review the recent literature and discuss recommendations for updating the practice guidelines previously published by this group in the Journal of Clinical Oncology in 1998. MEDLINE searches were performed and the relevant literature published since 1998 was reviewed by all panel members.