A new figure in oncology pathways: Oncology Nurse Navigator and his preliminary results in the San Benedetto del Tronto Surgery

From Top Italian Scientists Journal
Published
March 6, 2024
Title
A new figure in oncology pathways: Oncology Nurse Navigator and his preliminary results in the San Benedetto del Tronto Surgery
Authors
Ilenia Merlini, Salomone Di Saverio
DOI
10.62684/WVQV9876
Keywords
Oncology Nurse Navigator
Downloads
Download PDF
Download PDF

Ilenia Merlini(a), Salomone Di Saverio(b)

(a) AST Ascoli Piceno, Department of Surgery, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy

(b) AST Ascoli Piceno, Department of Surgery, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy. ORCID ID: 0000-0001-5685-5022

Correspondence to: Ilenia Merlini, AST Ascoli Piceno, Department of Surgery, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy Email: ilenia.merlini@hotmail.it, ilenia.merlini@sanita.marche.it ORCID ID: 0009-0005-5912-2453


Abstract

Background

The role of the Nurse Navigator was developed in order to address the health disparities created by the social determinants of health, , being an expert, specialized and trained nurse who takes charge of the patient diagnosed with cancer and accompanies him throughout the treatment process, helping him to extricate himself from the labyrinth of the healthcare system. This figure was introduced and studied in the general surgery of the Madonna del Soccorso hospital in San Benedetto del Tronto.

Objective

Primary outcomes are the reduction of time interval between the first patient contact and each phase of the diagnostic and therapeutic pathway. Secondary outcomes are the assessment of the number and frequency of contacts between the patient and the ONN, as well as of the number and type of organized procedures, and patient satisfaction assessment.

Methods

A prospective cohort study was conducted with a historical control group represented by the same number of cancer patients treated in the same surgical unit in the previous year and not followed by an ONN. The patients’ contacts were registered within a dedicated mobile number. A questionnaire on patient satisfaction with cancer care was completed and administered to patients in a blinded manner by a third party to avoid bias.

Results

The study group included 30 cancer patients. The average time from first contact to primary diagnostic test was 8 days versus 20 days in 2022 (control group). All patients underwent discussion by a multidisciplinary team (MDT), and the time to reach the MDT discussion was not different between the 2 groups. Five patients were deemed ineligible for surgery, and the average time to referral to a medical oncologist was 2 days in the study compared to 10 days in the control group. Twenty-five patients were eligible for initial surgery, and the mean time from first contact to surgery was 23 days after ONN establishment compared with 45 days in the control group. Each patient had an average of 10 phone calls with the ONN. For patients with a first diagnosis of cancer, the ONN organized an average of 4 tests. A patient satisfaction questionnaire achieved a response rate of 100%, with an average score of 85.2/90.

Conclusion

The data demonstrate that ONN service is effective and may improve the quality and outcomes of the management path of surgical oncology patients. The professional role of the ONN, with predefined technical and non-technical skills, should also be officially recognized by the healthcare system and hospital administration.

Declarations

Conflict of Interest

The Authors declare that there is no conflict of interest.

References

  1. Department of Health and Human Services. (n.d.). Social determinants of health. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
  2. ODPHP (Office of Disease Prevention and Health Promotion). Social Determinants of Health. 2020a. [November 9, 2020]. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
  3. Colorado Coalition for the Medically Underserved. [CCMU]. (2003). Social determinants of health
  4. National Cancer Institute. (2008). About Cancer health disparities. https://www.cancer.gov/about-nci/organization/crchd/about-health-disparities
  5. World Health Organization. (n.d.a.) Equity. http://www.who.int/healthsystems/topics/equity/en/
  6. Freeman, H. P., & Rodriguez, R. L. (2011). History and principles of patient navigation. Cancer, 117(15 Suppl):3539‐3542. doi: 10.1002/cncr.26262.
  7. Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature. Raymond J. Chan RN, PhD, Vivienne E. Milch MBBS(Hons), MHPol, Fiona Crawford-Williams PhD, Oluwaseyifunmi Andi Agbejule BRadTherapy, Ria Joseph MNutrDiet, Jolyn Johal BND(Hons), Narayanee Dick BSc(Hons), Matthew P. Wallen PhD, Julie Ratcliffe PhD, Anupriya Agarwal MBBS, Larissa Nekhlyudov MD, Matthew Tieu PhD, Manaf Al-Momani BPharm, Scott Turnbull PhD, Rahul Sathiaraj MPH, Dorothy Keefe MBBS, MD, Nicolas H. Hart PhD. 26 June 2023 https://doi.org/10.3322/caac.21788
  8. Advancing the Field of Cancer Patient Navigation: A Toolkit for Comprehensive Cancer Control Professionals. https://aonnonline.org/images/resources/navigation_tools/2020-AONN-Navigation-Metrics-Toolkit.pdf
  9. STRUSOWSKI, Tricia, et al. AONN+ Announces Standardized Navigation Metrics. Journal of Oncology Navigation & Survivorship, 2016, 7.9.
  10. MERLINI, Ilenia, et al. The First Experience in Italy of Oncology Nurse Navigator in a General Surgery Unit. Journal of Oncology Navigation & Survivorship, 2023, 14.11.