The Nurse Practitioner Role in Complex Malignant Hematology: A Qualitative Descriptive Study

Area of Science:

• Hematology
• Oncology Nursing
• Healthcare Management

Background:

• Limited international evidence exists on nurse practitioner (NP) roles in complex malignant hematology (CMH).
• A Canadian CMH program has utilized NPs for 20 years without prior evaluation.
• Stakeholder perceptions of NP roles in CMH are not well understood.

Purpose of the Study:

• To explore stakeholder perceptions of NP role structures, processes, and outcomes in CMH.
• To assess how NP roles meet patient and health service needs within a CMH program.
• To identify factors influencing NP role implementation and effectiveness in CMH.

Main Methods:

• Qualitative descriptive study guided by the PEPPA-Plus framework.
• Purposive sampling for focus groups and interviews with patients and healthcare professionals.
• Content analysis of qualitative data to identify key themes.

Main Results:

• Identified themes related to program evolution, care models, and strategic vision for NP roles.
• Highlighted accessible, comprehensive, and holistic care delivery by NPs, alongside workload challenges.
• Observed positive and negative outcomes but noted a lack of formal outcome measurement.

Conclusions:

• NP role implementation and outcomes are influenced by patient/NP characteristics, organizational change, staffing, and work organization.
• Organizational structures require enhancement to improve CMH care models and NP role optimization.
• NPs contribute value through comprehensive care, safety focus, and addressing social determinants of health; further research on outcomes is essential.