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Does certification status of oncology nurses make a difference in patient outcomes?
Marilyn Frank-Stromborg1, Sandra Ward, Linda Hughes
1School of Nursing, Northern Illinois University, Dekalb, IL, USA. cancer@niu.edu
Purpose/Objectives:
To test hypotheses that patients cared for by Oncology Certified Nurses (OCNs(r)) have superior outcomes compared to those cared for by noncertified nurses.
Design:
Descriptive ex post facto.
Setting:
A homecare agency in the midwestern United States.
Sample:
20 nurses (7 certified and 13 noncertified) and charts for 181 of their patients.
Methods:
Retrospective chart review.
Main Research Variables:
Symptom management (i.e., pain and fatigue), adverse events (e.g., infection and decubitus ulcers), and episodic care utilization (e.g., visits to care facilities, admissions to care facilities, unscheduled home visits).
Findings:
Contrary to hypotheses, the two groups did not differ with respect to assessment of pain at admission, number of pain assessments subsequent to admission, assessment of fatigue at admission, number of unplanned visits to care facilities, admissions to care facilities, and number of unscheduled home visits. As hypothesized, the OCNs(r) documented a higher number of postadmission fatigue assessments (p less than 0.05). Contrary to hypotheses, patients of OCNs(r) had a greater number of infections and fewer documented instances of patient teaching regarding infection.
Conclusions:
Little support was found for the hypothesis that nursing care by OCNs(r) results in superior patient outcomes in comparison to care by noncertified nurses.
Implications For Nursing:
Further research is needed to examine the dimensions of clinical practice that may demonstrate the benefits of care by OCNs(r).