Setting the Bar: Developing Quality Measures and Education Programs to Define Evidence-Based, Patient-Centered, High-Quality Care

Fessele, Kristen L; Yendro, Susan; Mallory, Gail

doi:10.1188/14.cjon.s2.7-11

Cited by 18 publications

(15 citation statements)

References 8 publications

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“…Instead, clinicians should be adopting a proactive approach in the assessment and intervention of BCRL. Through participation in the ONS Foundation-supported Breast Cancer Survivorship (BCS) Quality Measures Set pilot study (Fessele, Yendro, & Mallory, 2014), the authors found the assessment of lymphedema practices at the Springfield Clinic to be less than optimal. The pilot project compelled the authors to look at the current process and workflow related to the care of patients with breast cancer, particularly in the area of lymphedema.…”

Section: Introductionmentioning

confidence: 99%

Prospective Protocol for Lymphedema Education and Surveillance in a Breast Health Center

Haley-Emery

Schmitz-Johnson

2014

Clinical Journal of Oncology Nursing

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Participation in the ONS Foundation-supported Breast Cancer Survivorship Quality Measures Set pilot study indicated less than optimal assessment and educational practices for lymphedema surveillance at one author's institution. This finding led staff to expand on nursing practice associated with lymphatic dysfunction and to propose a surveillance tool that is easy to use in a busy clinical setting. Based on current trends in lymphatic surveillance, arm measurements were used to assess for relative percentage differences compared to baseline. The referral threshold for lymphedema diagnosis was set at a 10% relative difference in circumferential measurements, pre- and postoperatively, as well as during the survivorship period. Enhanced education efforts, inclusive of staff and patients, will be established throughout the continuum of care. As lymphedema research and standard of care consensus become established, this surveillance model will be adapted in accordance with evidence-based practice guidelines.

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Section: Introductionmentioning

confidence: 99%

Prospective Protocol for Lymphedema Education and Surveillance in a Breast Health Center

Haley-Emery

Schmitz-Johnson

2014

Clinical Journal of Oncology Nursing

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“…Leadership is about building relationships, and ONS provides a forum to join together experts of all oncology practice backgrounds, which is also the case with the ONS Foundationsupported Breast Cancer Care (BCC) Quality Measures Set pilot study (Fessele, Yendro, & Mallory, 2014). The VHA's unique role afforded diversity with the population of women veterans and geographic diversity, with women from rural to urban and large to small settings.…”

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confidence: 98%

Paths to Partnership: Veterans Health Administration's Journey in Pilot Testing Breast Cancer Care Quality Measures

Hogg

2014

Clinical Journal of Oncology Nursing

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Prioritizing personalized, proactive, patient-driven health care is among the Veterans Health Administration's (VHA's) transformational initiatives. As one of the largest integrated healthcare systems, the VHA sets standards for performance measures and outcomes achieved in quality of care. Evidence-based practice (EBP) is a hallmark in oncology nursing care. EBP can be linked to positive outcomes and improving quality that can be influenced directly by nursing interventions. VHA oncology nurses had the opportunity to partner with the Oncology Nursing Society (ONS), ONS Foundation, and the Joint Commission in the multiyear development of a comprehensive approach to quality cancer care. Building on a platform of existing measures and refining measurement sets culminated in testing evidence-based, nursing-sensitive quality measures for reliability through the ONS Foundation-supported Breast Cancer Care (BCC) Quality Measures Set. The BCC Measures afforded the VHA to have its many sites collectively assess documentation of the symptoms of patients with breast cancer, the use of colony-stimulating factors, and education about neutropenia precautions provided. Parallel paths of the groups, seeking evidence-based measures, led to the perfect partnership in the VHA's journey in pilot testing the BCC Measures in veterans with breast cancer. This generated further quality assessments and continuous improvement projects for spread and sustainability throughout the VHA.

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“…One of the Quality measures was to ascertain the percentage of patients beginning chemotherapy who received counseling about exercise as an intervention to combat fatigue. 14 …”

Section: 5mentioning

confidence: 99%

“…1,15,16 According to the ONS, about 10% of patients with breast cancer received recommendation to exercise in order to reduce their fatigue. 14 Nurses' management of illnesses is influenced by their beliefs about the effectiveness of the treatment. Treatment beliefs of nurses affected the degree to which they managed patients undergoing cervical cancer screening.…”

Section: Background and Conceptual Frameworkmentioning

confidence: 99%

Factors Related to Oncology Nurses’ Exercise Counseling for Management of Fatigue of Women during Treatment for Breast Cancer

Shing¹

2017

NCOAJ

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Purpose: To identify and explore the predictors of nurses' exercise counseling for the management of fatigue of women during treatment for breast cancer.Design: Descriptive correlational. Setting:Registered nurses who were current members of the Oncology Nursing Society.Sample: 115 nurses working in oncology settings, providing direct care to adult women receiving treatment for breast cancer.Methods: Nurses completed a demographic questionnaire, an Exercise Questionnaire, two Exercise Beliefs, and one Exercise Counseling Behaviors Scales. Main research variables:personal experience with exercise, exercise barriers beliefs, exercise benefits beliefs, exercise counseling behaviors.Findings: Exercise barriers beliefs, the nurse's current position nurse, and knowledge about National Comprehensive Cancer Network (NCCN) guidelines predicted exercise counseling behaviors. Conclusion:Nurses' beliefs about exercise barriers are most important to their exercise counseling for women with breast cancer and cancer-related fatigue (CRF). Implications for nursing:Educational programs are needed to improve nurses' knowledge about standards of care for the treatment of CRF. Strategies need to be developed to assist patients to overcome barriers and promote nurses' exercise counseling behaviors.Knowledge Translation i. Nurses who believe in the benefits of exercise, but also have strong beliefs that women with breast cancer experiencing CRF have many barriers to exercise, tend not to counsel them to exercise.ii. Nurses may need to explore strategies to increase their exercise counseling behaviors in the presence of their personal beliefs about exercise barriers.iii. Nurse leaders could mentor staff nurses to alter the impact of exercise barriers beliefs.Keywords: exercise beliefs, fatigue, counseling, knowledge, behaviors, nurse leaders, cancerNursing & Care Open Access Journal Research ArticleOpen Access Factors related to oncology nurses' exercise counseling for management of fatigue of women during treatment for breast cancer 78Copyright: ©2017 Shing Citation: Shing DH. Factors related to oncology nurses' exercise counseling for management of fatigue of women during treatment for breast cancer. Nurse Care Open Acces J. 2017;2(3):77-83. DOI: 10.15406/ncoaj.2017.02.00037and counseling during treatment to motivate women with breast cancer to exercise, thus minimizing their fatigue. The Oncology Nursing Society Foundation came to the same conclusion after supporting the development of the Breast Cancer Care Quality Measure's set. One of the Quality measures was to ascertain the percentage of patients beginning chemotherapy who received counseling about exercise as an intervention to combat fatigue. 14 Background and conceptual frameworkCurrently, nurses' management of fatigue is inconsistent with national treatment guidelines, which recommend that exercise counseling includes encouraging patients with CRF to exercise. 1,15,16 According to the ONS, about 10% of patients with breast cancer received recommendation to exercise...

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Setting the Bar: Developing Quality Measures and Education Programs to Define Evidence-Based, Patient-Centered, High-Quality Care

Cited by 18 publications

References 8 publications

Prospective Protocol for Lymphedema Education and Surveillance in a Breast Health Center

Prospective Protocol for Lymphedema Education and Surveillance in a Breast Health Center

Paths to Partnership: Veterans Health Administration's Journey in Pilot Testing Breast Cancer Care Quality Measures

Factors Related to Oncology Nurses’ Exercise Counseling for Management of Fatigue of Women during Treatment for Breast Cancer

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