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Objectives: The objectives of this study were to gather emerging practice evidence, through consultation with Advance Practice Nurses (APN), to fill the evidence gaps in the published guidelines, Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario, and to provide a set of expert panel recommendations to build a research agenda to promote the collection and publication of Level 1 and 2 evidence. Method: A three-step RAND/UCLA Appropriateness Methodology (RAM) modified Delphi process was used to solicit expert opinion on the use of APNs in adult cancer care in Ontario. Results: Thirty-four (34) case examples of APN use were gathered. The modified Delphi process concluded with the endorsement of 30 APN role statements that were used to develop nine (9) additional recommendations regarding the use of APNs in the delivery of adult cancer care. Conclusion: The recommendations from this study provide direction for future research to close the current evidence gap regarding the role of APNs in cancer care delivery in Canada.
Objectifs : La présente étude avait pour but de recueillir, en consultation avec les infirmières en pratique avancée (IPA), des données probantes sur les pratiques émergentes afin de combler les lacunes à cet égard dans les lignes directrices sur le recours judicieux aux infirmières en pratique avancée dans la prestation des services aux adultes atteints de cancer en Ontario (Effective Use of Advanced Practice Nurses in the Delivery of Adult Cancer Services in Ontario), ainsi que de proposer un ensemble de recommandations, formulées par un groupe d'experts, pour créer un programme de recherche qui permettra de recueillir et de publier des données probantes de niveau 1 et de niveau 2. Méthodologie : Une enquête Delphi modifiée à trois tours faisant appel à la méthodologie mise au point par RAND et UCLA (aussi appelée « Appropriateness Methodology ») a été utilisée pour solliciter l'avis des spécialistes sur le recours aux IPA pour le soin des adultes atteints de cancer en Ontario. Résultats : Trente-quatre (34) cas de recours aux IPA ont été recensés. L'enquête Delphi modifiée a permis de définir 30 énoncés de rôle à partir desquels ont été formulées neuf (9) recommandations supplémentaires sur l'intervention des IPA dans la prestation des soins aux adultes atteints de cancer. Conclusion : Les recommandations de la présente étude orienteront les recherches à venir pour combler les lacunes au chapitre des données probantes quant au rôle des IPA dans la prestation des soins du cancer au Canada. iNtrODuctiON L e cancer est la principale cause de décès au Canada. La population vieillit et on prévoit, d'ici 2030, une augmentation de plus de 80 % du nombre de diagnostics de cancer par rapport à 2005 (Société canadienne du cancer/Canadian Cancer Society, 2017). Cette hausse exerce de plus en plus de pression sur le système de santé. Toutefois, la recension systématique des écrits montre que les infirmières en pratique avancée (IPA) peuvent améliorer la santé des patients et la qualité des soins pour différentes populations tout en diminuant le recours aux soins de santé et le coût qui y est associé (Bryant
Catherine Kiteley is a registered nurse holding a Masters of Science degree from the University of Toronto and certifications in Oncology CON(C) and Palliative care CHPCN(c), She currently works as a Clinical Nurse Specialist in supportive care with a focus in oncology and palliative care at The Credit Valley Hospital, the Peel Regional Cancer Centre . Catherin e has been a nurse professional for 30 years and has held a variety of nursing positions including, staff nurse, nurse educator, nursing unit administrator and program director. She derives much job satisfaction in her current role as an advanced practice nurse as it enables her participation in not only clinical practice, but education, research and organizational leadership. In addition to working at the hospital, Catherine holds a clinical appointment with the University of Toronto where she teaches and provides mentorship for graduate nursing students. She is also published in a number of scholarly journals and speaks at regional, national and international conferences on various topic areas related to cancer nursing.
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