UICC World Cancer Congress 2006

Quantifying nursing time in the oncology ambulatory care area is challengingdue to the unpredictability of the patient population. Oncology outpatients have multiple complex needs often requiring multiple treatments with each visit. Patients seen for routine blood work may end up requiring an admission for fever and neutropenia. Caring for patients in this environment requires astute judgment and meticulous care from the nursing staff.

Objective: Using the Plan, Do, Check, Act Model, the presenters for this session will discuss the development, implementation and evaluation of an intensity system that was piloted and adapted in the Hematology/Oncology Day Hospital of the National Institutes of Health.

Methods: The system provides a mechanism to objectively measure the amount of direct and indirect care required to provide comprehensive care to the ambulatory oncology patient. It is used to assist with staffing, productivity and staff development needs. Nurses select the highest level of care required byeach patient. Levels are then equated to a time factor.

Results: The intensity system enhances the use of critical thinking skills as nurses closely examine their daily workload expenditure. The system may be easily adapted to any care setting and may be used as a performance improvement tool to identify missing documentation and clarify role responsibilities. Measuring patient intensity in the ambulatory oncology population is essential in providing an objective method to predict staffing needs in the delivery of safe and comprehensive care.