Caring for people with cancer: Nurses professional and career - PowerPoint PPT Presentation

Caring for people with cancer: Nurses’ professional and career development needs Denise Bryant-Lukosius, Mary Jane Esplen, Esther Green, Grace Bradish, Tazim Virani, Diana Morarescu CANO 2010 Conference – Edmonton, AB

Objectives Objectives  Highlight the objectives and methods of a provincial assessment of nurses’ professional development needs in cancer control.  Highlight the critical role of stakeholders for conducting an effective needs assessment.  Summarize key findings/recommendations for meeting the professional development needs of generalist and specialized nurses who provide cancer care.  Introduce new resources in the expanded Oncology Nursing e-Mentorship Program

Background Background Ontario Oncology APNs had identified significant need for mentorship and role development support: – A survey of community of practice (APN-COP) members – Needs assessment studies & Cancer Care Ontario Consensus meetings (Bryant-Lukosius et al., 2007; CCO 2006 & 2008) • Led by the Mentorship Sub-Committee of the APN- COP an e-Mentorship Program was established and evaluated in 2008 with the aid of funding from the MoHLTC.

Oncology APN –Mentorship Oncology APN –Mentorship Program Evaluation Results Program Evaluation Results Modest investments in mentorship over 2 months had significant impact – Improved mentorship knowledge, skills, confidence & readiness – Improved APN intra/interprofessional collaboration – Improved APN skills & activities related to research, EBP & leadership – Improved APN job satisfaction: time & professional, social community interaction

Implications Implications  A formalized program with structured education components & access to support prepares participants for mentorship & promotes their transition through mentorship stages  An e-based approach increases access to APN mentors & is appropriate, feasible & acceptable  Interprofessional mentorship was appropriate & acceptable & increases APN access to mentors

Program Expansion Fall 2008 Program Expansion Fall 2008  New program partner with long-term funding to 2013  Expansion to include services for all nurses who care for adult/pediatric populations at risk for or affected by cancer in Ontario

Provincial Needs Assessment Provincial Needs Assessment Purpose To identify the professional development needs of  generalist and specialized oncology nurses (CANO, 2001) across the cancer continuum in Ontario that may be met through coaching, preceptorship and/or mentorship. To examine the feasibility of providing such  supports and the types of models that may be most appropriate for specific sub-groups of nurses involved in cancer control.

Professional Development Professional Development “The ongoing commitment to ensure that your skills and ability to implement your role in oncology nursing are relevant and up to date.”

Provincial Advisory Committee Provincial Advisory Committee (n= 16) (n= 16) Generalist, specialized & advanced RNs • Clinical managers, senior administrators, regional VP • Nurse educators & faculty • Allied health providers, e-learning & technical experts • Researchers, LHIN – health planners, provincial decision- • makers RNs with adult, pediatric, oncology, palliative, or public • health expertise Tertiary acute care & community hospitals, community • nursing agencies, home care & primary health care settings Urban, rural & remote settings •

Provincial Advisory Committee Provincial Advisory Committee  Participated by teleconference/email to: – Develop needs assessment objectives & research questions – Design data collection plan – Provide feedback on data collection tools – Facilitate recruitment of participants  One day onsite meeting to develop recommendations about program priorities and design of new program  Final teleconference for input on draft report and program plan

Assessing Needs Assessing Needs  Vision/strategies for nursing capacity development in cancer care within organizations/programs/regions  Clinical priorities for improving patient care through enhanced nursing knowledge and skill  Priorities for nursing competency development  Effectiveness of ways RNs currently address professional development needs  Variability in professional development needs among different types of RN groups across the cancer continuum

Assessing Feasibility & Assessing Feasibility & Implementation Issues Implementation Issues  RN readiness & preferences for accessing coaching, preceptorship, mentorship services  Availability of existing services & expertise  Potential best practice mentorship models or features  Personal, organizational & health system barriers & facilitators to RN participation  Integration with existing APN program

Methods of Data Collection Methods of Data Collection Generalist & Specialized Oncology Nurses  Online survey & telephone focus groups Key Decision Makers  Managers & senior nursing & non-nursing administrators  Telephone focus groups & interviews Supportive Key Informants  APNs, faculty & in-house educators, interprofessionals  Telephone focus groups & interviews  APN mentors also completed online survey

Recruitment Strategies Recruitment Strategies – Personalized invitation on program letterhead tailored to specific key informant groups – Reminders & recruitment updates – Scheduled & adhoc/flexible meeting times – Telephone interviews & focus groups – Program Champions  Project team, advisory committee, current program participants  Personal contact, invitation to participate & promote needs assessment  Maximized use of their contacts, networks & list serves

Data Management & Analysis Data Management & Analysis  Interviews & focus groups – Audiotaped & transcribed – Content analysis to identify key themes  Survey – Descriptive statistics: frequency counts, percentages

Results Results  Focus Groups  13 teleconference focus groups/interviews  76 participants from various backgrounds  18 APNs  19 RNs/Staff Nurses  22 Managers/Directors/Coordinators  2 Faculty Members  5 Educators  6 Health Promoters/Genetic Counsellors  1 Researcher  3 New Grads - RNs

Results Results  Electronic survey – Completed by 619 nurses • Adult & paediatric • Regional Cancer Centres • Tertiary Care • Community Hospitals • Small Town/Rural/Remote • Community/home care • Public health/health promotion • Palliative care/Hospice • Geographic spread – 79% of participants completed all 34 questions

Demographic Survey Data Demographic Survey Data  Nursing profile – Over 60% were generalists – 62% were diploma prepared – 58% had 20+ years of RN experience – 47% had 10+ years of oncology experience – 42% worked in a community hospital – 82% care for adult patients – 32% had CON (C)

Results – Role Development Needs Results – Role Development Needs  Identified a broad range of oncology professional development needs  Most frequently reported needs related to: – Assessment & management of disease & treatment related complications/side effects – Health promotion & cancer prevention – Psychosocial interventions – Palliative care

Results – Role Development Needs Results – Role Development Needs  Some differences in the frequency of reported needs among various types of nurses: – Those with/without oncology or palliative care certification – Those working in cancer centre, tertiary care hospitals, community hospitals and the community – Generalist and specialized nurses

Results – Career & Professional Results – Career & Professional Development Experience Development Experience  28% had engaged in a formal career planning process  51% had a professional development plan

Professional Development Professional Development Facilitators (n=619) Facilitators (n=619)  Top 5 most frequently reported – Personal motivation (49%) – Internet & e-learning (45%) – Management support (38%) – Local access to programs (35%) – Funding (35%)

Professional Development Professional Development Barriers (n=619) Barriers (n=619)  Top 5 most frequently reported – Lack of funding (43%) – Not able to get time off work (41%) – Staff shortages (40%) – Lack of skilled replacement staff (22%) – Lack of organizational support (18%)

Service Delivery Preferences Service Delivery Preferences  Intra (38%) versus interprofessional (20%) or distance mentorship (19%)  Traditional, step ahead or peer nurse mentor from one’s own organization vs outside of organization  No difference in willingness to participate in coaching, preceptorship or mentorship

Support Needs for Participating in Support Needs for Participating in Professional Development Activities Professional Development Activities Top 5 most frequently reported (n= 619):  Resources to increase knowledge about effective coaching, preceptorship, mentorship (51%)  Practical tools (50%)  Identifying a suitable coach, mentor, preceptor (48%)  Release time from work (43%)  Facilitate supervisor/employer support (39%)