Impact of the clinical nurse specialist role for the myeloproliferative neoplasm program: Part One – From timeliness of triage to cost-saving
Abstract
Myeloproliferative neoplasms (MPNs) are a group of rare clonal disorders of hematopoietic progenitor cells associated with disease-related symptoms, thrombotic events, and risk of transformation to acute myeloid leukemia (Tefferi, 2021). The relative rarity and complexity of care led to the establishment of the MPN program at the Princess Margaret (PM) Cancer Centre. The MPN program utilizes a shared-care model wherein partnering with local hematologists (shared-care partners) ensures that patients have access to an MPN specialist while continuing to receive care close to home (Cheung et al., 2021). The clinical nurse specialist (CNS) role was implemented in late 2016 to support not only the shared-care model, but also to triage new patient referrals, and support consultation and follow-up. Although the CNS roles have been part of the healthcare system since the 1940s, the role and its impact remain unclear at times to the inter-disciplinary team. This paper will describe the process and results from evaluating the CNS role’s impact in the MPN program using a multimethod approach. This is part one of two papers; herein the quantitative findings are presented, and part two will discuss the qualitative findings.
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Canadian Nursing Association. (2012, December 4). Strengthening the role of the clinical nurse specialist in Canada. https://www.cna-aiic.ca/-/media/cna/page-content/pdf-fr/strengthening_the_cns_role_background_paper_e.pdf?la=en&hash=F2D0FBBCA236CE4F620348B4FED5FE5615A5B373
Canadian Nurses Association. (2019). Advanced practice nursing: A Pan-Canadian Framework. https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/apn-a-pan-canadian-framework.pdf
Cancer Care Ontario. (2018a, January). Clarifying the role of clinical nurse specialist and nurse practitioners in delivery of Cancer Care in Ontario. https://www.cancercareontario.ca/en/content/clarifying-roles-clinical-nurse-specialists-and-nurse-practitioners-delivery-cancer-care-ontario
Cancer Care Ontario. (2018b, January). Expert recommendation report on clinical nurse specialist and nurse practitioner roles in the delivery of adult cancer services in Ontario. https://www.cancercareontario.ca/en/content/expert-recommendation-report-clinical-nurse-specialist-and-nurse-practitioner-roles-delivery-adult-cancer-services-ontario
Cheung, V., Brown, J., Julius, A., Mitchell, L., Moura, S., & Jin, R. (2022). Guiding the clinical nurse specialist role in oncology within Princess Margaret Cancer Centre. Canadian Oncology Nursing Journal, 32(3), 357–365. https://doi.org/10.5737/23688076323357
Cheung, V., Siddiq, N., Devlin, R., McNamara, C., & Gupta, V. (2021). Shared-care model for complex chronic haematological malignancies. Canadian Oncology Nursing Journal, 31(2), 165–174. https://doi.org/10.5737/23688076312165174
Cook, O., McIntyre, M., & Recoche, K. (2015). Exploration of the role of specialist nurses in the care of women with gynaecological cancer: A systemic review. Journal of Clinical Nursing 24(5-6), 638–695. https://doi.org/10.1111/jocn.12675
Cook, O., McIntyre, M., Recoche, K., & Lee, S. (2019). “Our nurse is the glue for our team” – Multidisciplinary team members’ experiences and perceptions of the gynaecological oncology specialist nurse role. European Journal of Oncology Nursing, 41, 7–15. https://doi. org/10.1016/j/ejon.2019.05.004.
Cooper, M. A., McDowell, J., Raeside, L., & the ANP-CNS Group. (2019). The similarities and differences between advanced nurse practitioners and clinical nurse specialists. British Journal of Nursing, 28(20), 1308–1314. https://doi.org/10.12968/bjon.2019.28.20.1308
Dempsey, L., Orr, S., Lane, S., & Scott, A. (2016). The clinical nurse specialist’s role in head and neck cancer care: United Kingdom National Multidisciplinary Guidelines. The Journal of Laryngology & Otology, 130(S2), S212–S215. https://doi.org/10.1017/S0022215116000657
Donald, F., Bryant-Lukosius, D., Martin-Misener, R., Kaasalainen, S., Kilpatrick, K., Carter, N., Harbman, P., Bourgeault, I., & DiCenso, A. (2010). Clinical nurse specialist and nurse practitioners: Title confusion and lack of role clarity. Nursing Leadership, 23, 189–210. http://doi.org/10.12927/cjnl.2010.22276
Hale, I. (2015). Add to cart? Canadian family physician Medecin de famille canadien, 61(11), 937–944.
Jordan, J., Gage, H., Benton, B., Lalji, A., Norton, C., & Andreyev, H. J. N. (2017). Gastroenterologist and nurse management of symptoms after pelvic radiotherapy for cancer: An economic evaluation of a clinical randomized controlled trial (the ORBIT study). ClinicoEconomics and Outcomes Research, 9, 241–249. https://doi.org/10.2147/CEOR.S122104
Kerr, H., Donovan, M., & McSorley, O. (2021). Evaluation of the role of the clinical nurse specialist in cancer care: An integrative literature review. European Journal of Cancer Care. https://doi.org/10.1111/ecc.13415
Kilpatrick, K., DiCenso, A., Bryant-Lukosius, D., Ritchie, J. A., Martin-Misener, R., & Carter, N. (2013). Practice patterns and perceived impact of clinical nurse specialist roles in Canada: Results of a national survey. International Journal of Nursing Studies 50, 1524–1536. http://dx.doi.org/10.1016/j.ijnurstu.2013.03.005
Kilpatrick, K., DiCenso, A., Bryant-Lukosius, D., Ritchie, J. A., Martin-Misener, R., & Carter, N. (2014). Clinical nurse specialist in Canada: Why are some not working in the role? Nursing Leadership, 27(1) 62–75. https://doi.org/10.12927/cjnl.2014.23738
Kilpatrick, K., Kaasalainen, S., Donald, F., Reid, K., Carter, N., Bryant-Lukosius, D., Martin-Misener, R., Harbman, P., Marshall, D. A., Charbonneau-Smith, R., & DiCenso, A. (2014). The effectiveness and cost-effectiveness of clinical nurse specialist in outpatient roles: A systemic review. Journal of Evaluation in Clinical Practice, 20, 1106–1123. http://doi.org/:10.1111/jep.12219
Mayo, A. M., Ray, M. M., Chamblee, T. B., Urden, L. D., & Moody, R. (2017). The advanced practice clinical nurse specialist. Nursing Administration Quarterly, 41(1), 70–76. http:// doi.org/10.1097/NAQ.0000000000000201
Ministry of Health Ontario Health Insurance Plan Laboratories and Diagnostic Branch. (2023). Schedule of benefits for laboratory services. https://www.health.gov.on.ca/en/pro/programs/ohip/sob/lab/sob_lab_2023.pdf
Mitchell, L., Stuart-McEwan, T., Panet, H., & Gupta, A. A. (2017). Adolescents and young adults addressing needs and optimizing care with a clinical nurse specialist. Clinical Journal of Oncology Nursing, 21 (1), 123–126. http://doi.org/10.1188/17.CJON.123-126
Moore, J., & McQuestion, M. (2012). The clinical nurse specialist in chronic diseases. The Clinical Nurse Specialist. 26(3), 149–163. http://doi.org/10.1097/NUR.0b013e3182503fa7
Morgan, B., & Tarbi, E. (2016). The role of the advanced practice nurse in geriatric oncology care. Seminars in Oncology Nursing, 31(1), 33–43. http://dx.doi.org/10.1016/j.soncn.2015.11.005
Parker, J. M., & Hill, M. N. (2017). A review of advanced practice nursing in the United States, Canada, Australia and Hong Kong Special Administrative Region (SAR), China, International Journal of Nursing Sciences, 4(2), 196–204. https://doi.org/10.1016/j.ijnss.2017.01.002
Pollard, C. A., Garcea, G., Pattenden, C. J., Curran, R., Neal, C. P., Berry, D. P., & Dennison, A. R. (2010). Justifying the expense of the cancer clinical nurse specialist. European Journal of Cancer Care, 19, 72–79. https://doi.org/10.1111/j.1365-2354.2008.01000.x.
Tefferi, A. (2021). Primary myelofibrosis: 2021 update on diagnosis, risk-stratification and management. American Journal of Hematology, 96(1), 145–162. https://doi.org/10.1002/ajh.26050
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