A pan-Canadian environment scan of brachytherapy services and nursing practice

Abstract

Introduction: Brachytherapy is a type of cancer treatment that utilizes seeds, wires, balloons, needles, ribbons, or capsules containing radioactive isotopes, which are inserted into the patient’s body to deliver radiation. Patients undergoing brachytherapy often report the procedure as a traumatic event, reporting general feelings of vulnerability, discomfort, and fear. The current practices of nurses in brachytherapy are not well delineated and the organization of these services can vary significantly across centres. Thus, this study aimed to explore the current brachytherapy nursing practices in Canada.

Methods: This study utilized a cross-sectional survey developed by an expert committee, which included the Canadian Association of Nurses in Oncology/Association canadienne des infirmières en oncologie (CANO/ACIO) co-chairs of the Radiation and Gynecology Oncology special interest groups. The survey includes open-ended and closed-ended questions in both English and French distributed through FORMS in Microsoft office and sent out to the nurse members of the Radiation and Gynecology Oncology special interest groups with a request to participate.

Results: Twenty-six individuals responded to the survey. Overall, a majority of respondents reported practising in Ontario (34.6%) or Quebec (34.6%), and more than half reported working more than 7.6 hours per week in the brachytherapy suite. Only 26.9% reported certification in oncology nursing and 3.8% reported certification in perianesthesia nursing. Furthermore, 53.8% reported being familiar with Operating Room Nurses Association of Canada Standards. Half of the respondents reported experiencing ethical concerns, including moral distress. In the open-ended questions, participants discussed the “rough” nature of brachytherapy, lack of education, poor patient pain management, and the lack of resources.

Conclusion: CANO/ACIO’s mission is to advance excellence in nursing practice through leadership, advocacy, collaboration, and research, to uphold practice to high standards. Currently, brachytherapy education requirements remain underdeveloped, posing risks to the safety and well-being of both nurses and patients. As such, we outline the current state, as well as recommendations for a strong position statement, such as standardized brachytherapy nurse education and supports to ensure patients undergoing brachytherapy do so with adequate psychosocial care and pain management.