Those in attendance at the AONN second annual meeting had the opportunity to attend breakout sessions focused on navigation strategies in the following subject areas: breast cancer, lung cancer, gastrointestinal (GI) cancer, prostate cancer, multi-tumor types, as well as the management of a navigation program. It is our pleasure to offer the following summaries and takehome points from each session.
Sue Bowman, RN, OCN, CBCN, MSW Leesa Mattingly, RN, OCN
The breast cancer session focused on the use of the Nursing Process to guide navigation for people with breast cancer. A review of the Nursing Process theory was aligned to navigation using As sessment, Nursing Diagnosis, Creating a Plan of Care, Im plementing the Plan, and Evaluating the Plan. Practical application of the Nursing Process was described in relation to the steps of comprehensive navigation such as preparing for an initial assessment, building a rapport with the patient, and engaging the patient in their care. Promotion of a team approach and use of available resources for holistic care include the patient, physicians, and supportive services and was delineated. Developing logical ways to identify individual barriers and barrier resolution was discussed. The 2012 ACoS CoC Standards were reviewed in relation to the navigation, psychosocial assessment, and survivorship standard requirements. The Nursing Process was applied to developing individualized survivor programs in a way that participants could identify a need in their community and use that as a focus for their program. Interactive activities like Barrier Balls and Case Study kept the audience entertained and thinking in terms of practical tools and patient intervention.
Pamela Matten, RN, BNS, OCN Karen Overmeyer
As one of the most lethal cancers in the world, lung cancer presents numerous challenges in diagnosis and management. New evidence from the National Lung Screening Trial indicates that screening with low-dose CT may provide opportunity to detect lung cancer at earlier stages. This breakout session highlighted the role of the thoracic oncology nurse navigator in prevention and screening, and the importance of early detection of cancer with regard to diagnosis and treatment options. One of the multifaceted roles of the nurse navigator includes coordinating a multidisciplinary conference and clinic, putting all diseasespecific specialists together at one time and place to decide on a comprehensive treatment plan. Nursing navigation serves to expedite the pathway from suspicion to diagnosis and diagnosis to treatment on through to survivorship and/or palliative care, while collaborating with involved clinicians, keeping the patient and family at the helm of decision making. Case study presentations typified how the thoracic oncology nurse navigator weaves his/her role throughout thecontinuum of care, collaborating among clinicians and points of patient contact, providing support and education, and monitoring patients for side effects and effectiveness of therapies. In closing, the breakout session included a glimpse at the development of new frontiers in the treatment of lung cancer with respect to novel targeted agents and the use of molecular biomarkers.
The role of the thoracic nurse navigator:
Coralyn Martinez, MSN, RN, OCN Nicole Messier, RN, BSN
The goal of the GI cancer navigation break out session was to provide an in teractive forum for navigators to discuss current successes and ob stacles in developing and main taining a successful GI navigation program. An over view of 2 GI multi disciplinary programs was provided followed by small group breakout discussion. The small group discussion focused on types of navigation, developing focused navigation and programmatic goals, documentation, referral patterns, re sources, and measuring success.
Frank delaRama, RN, MSN, AOCNS
The prostate cancer navigator breakout session fo cused on 2 main areas: (1) program development/maintenance, and (2) shared decision making and role of the navigator. Through sharing the story of the development of the pro state cancer care program at Palo Alto Medical Foundation, many strategies and ideas were identified that can help grow and maintain a program of excellence, with the navigator leading the way.
Shanna Gillming, RN Jay R. Swanson, RN, BSN, OCN
The goal of our breakout session was to have an open discussion regarding concerns with multi-tumor site navigation, identify potential best practices, and review some case studies highlighting the strengths and difficulties of multi-tumor site navigation. We wanted to have an open discussion with each navigator involved.
Phyllis DeAntonio, RN, MSN, FAAMA Marie DeStefano, RN, MSN, FAAMA
Patient navigation is all the buzz in healthcare today. Every patient with an abnormal finding, whether malignant or not, wants a nurse navigator to guide them through this complex business we call health care. Navigation is as different and unique as the institution where the care is delivered, including the title of the navigator. In some institutions they are known as “nurse navigators,” and in others, “patient navigators.” They have been called “patient care coordinators,” “case managers,” and “patient care navigators.” Regardless of their title, the role remains the same. The purpose of the navigator is to assist the patients in receiving prompt quality care during this challenging time in their life in order to achieve the best outcome. While the overall goals are better patient outcomes, in an environment where justification of new positions is a constant challenge, it is important to gain support from administration for the ongoing success and funding of this position.
Some key points from an administrative view to remember about nursing navigation are:
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