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Research project: Quality in Cancer Nursing - Nurse Sensitive Outcome Indicators for Ambulatory Chemotherapy - Dormant - Dormant

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This project is developing a set of indicators, focused around effectiveness, safety and patient experience as a way of helping chemotherapy nursing teams reflect on their performance and help drive up quality. 

Monitoring outcomes provides a stimulus to develop services to improve the experience and health of patients. Validated nurse sensitive measures open the possibility of demonstrating the ‘added value’ of specialist nursing services and of using registered nurses in settings where they might be replaced by other, less qualified, staff. Without such measures and such evidence it may become hard to defend these posts in periods of financial constraint. This project is developing a set of outcome measures intended to be sensitive to the work of nurses in ambulatory cancer chemotherapy settings.

There are three elements to the project:

Element 1: Identification, piloting and feasibility testing of nurse sensitive outcome indicators system
The areas we identified as having sufficient evidence to support their use as outcomes indicators of high quality nursing care (Griffiths et al 2009) are:

  • Patient safety – safe medication administration
  • Clinical effectiveness – assessment and management of chemotherapy-induced nausea and vomiting
  • Patient experience – confidence and trust in oncology care providers, satisfaction with communication including ability to get answers to questions and information about accessing services  and appropriate self-care

Selection of the indicators will build on work already undertaken by the NHS Information Centre and, where possible, their methodology will be replicated in order to ensure suitability for inclusion in the Measuring Quality Improvement programme. We will consult with expert reference groups and representatives from potential pilot sites to ensure the selected nurse sensitive outcome indicators are able to meet the criteria of good indicators derived from The Association of Public Health Observatories. These are:

  • Do the indicators address the important issues?
  • Are they scientifically valid?
  • Is it possible and practical to populate the indicator with meaningful data?
  • What is the indicator telling you and how precise and reliable is the information?
  • What are the implications for practice?

These will then be piloted in a single site, refined and piloted again in a further three sites

Element 2: Liaison with national NHS initiative to ensure congruity

Element 3: Dissemination to a wide NHS audience to promote uptake of the nurse sensitive outcome indicators developed and tested during the project.

Project team

Peter Griffiths, Alison Richardson, Jessica Corner
Dr Jo Armes, King’s College London

Researcher:  Richard Wagland

Project funder

National Cancer Action Team through Institute for Innovation & Improvement

Associated research themes

Outcome measurement

Related research groups

Complex Healthcare Processes
Health Work and Systems
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