A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy.

Purpose/objectives: To examine the effects of a comprehensive rehabilitation program on facilitating physical and psychosocial adaptation of women with breast cancer who are receiving adjuvant chemotherapy.

Design: Experimental.

Setting: Breast evaluation clinics of two New England medical centers with comprehensive cancer treatment programs.

A hospital-based chemotherapy education and training program.

Impatient chemotherapy administered by nurses from the outpatient setting causes fragmentation of care by impeding the primary nursing model. The inpatient oncology nursing staff, highly motivated to expand their knowledge base for cancer patient care, expressed interest in chemotherapy administration. In a collaborative effort among the oncology clinical nurse specialist, nurse educator, and nurse manager, a program was designed based on The Oncology Nursing Society Cancer Chemotherapy Guidelines and Recommendations for Nursing Education and responses from an education-needs assessment survey.

Decreasing documentation time using a patient self-assessment tool.

A 1986 audit of 150 randomly selected radiation therapy patient records revealed 147 records containing completed nursing assessment and weekly progress notes. Documentation of care provided was comprehensive, but concern was expressed over the length of time it required--an average of 40 minutes for the patient interview and an additional 20 minutes for documentation. Two strategies were proposed to reduce the amount of time spent in documentation without jeopardizing the detail of information contained in the initial nursing assessment: to pilot a patient self-assessment tool based on our original functional health pattern nursing assessment and to develop a standard flow sheet that contained both frequently used nursing diagnoses and potential interventions.