Innovative examples of ways that advanced practice registered nurses (APRNs) may provide care were presented at the 46th Annual Oncology Nursing Society (ONS) Congress by Kathi Mooney, RN, PhD, FAAN, of the University of Utah, and Rosanne Casal, DNP, APN-BC, AOCNP, of the University Hospitals Seidman Cancer Center (SCC).

“The trajectory of APRNs in health care is breathtaking,” said Dr Mooney, who started the presentation with a discussion of programs that bring oncology care to the home, a setting where cancer care delivery could be enhanced. “I imagine it as the next frontier for oncology APRNs.”

The first program was a technology-based system for addressing symptoms at home, with algorithm-based coaching as a response to reported symptoms. In a randomized, controlled trial of 358 patients treated with chemotherapy, use of this system was associated with significantly reduced overall symptom burden (P <.001).


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The second program Dr Mooney described delivers acute hospital-level care to the patient’s home. At her center, this care is provided by nurse practitioners working in conjunction with services provided by a home health agency. An analysis showed an odds reduction in unplanned hospitalizations of 55% with this system (P <.001) in the 30 days after enrollment.

In her segment, Dr Casal discussed 3 specialty clinics at the SCC with prominent roles for advanced practice providers: a bone marrow biopsy clinic, a benign hematology clinic, and an ambulatory acute care clinic. Advanced practice nurses with sufficient training at SCC perform bone marrow biopsies. Physicians often explore roles in malignant hematology, leaving opportunities open for advanced practice providers to provide benign hematology care.

The acute care clinic, which originally focused on sickle cell disease, was expanded to include patients with cancer. These patients would otherwise be seen at emergency departments for treatment-related side effects, posing risks as they were often immunosuppressed. A pilot study showed oncology patients were using the clinic, with the vast majority able to go home afterward, rather than going to the emergency department.

Introducing APRNs as care team members sharing in patient management can be a helpful way to encourage patients to visit with them, reported Dr Casal.

Disclosure: One presenter declared affiliation with the pharmaceutical industry. Please refer to the on-demand presentation for a full list of disclosures.

Reference

Casal R, Mooney K. Thinking beyond the current roles of APRNs. Oral presentation at: 46th Annual ONS Congress; April 20-29, 2021. Accessed April 22, 2021.

This article originally appeared on Oncology Nurse Advisor