title: Delivering care to oncology patients in the community: an innovative integrated approach.
abstract: A community oncology nursing programme was developed in Ireland between the hospital and community health services for patients receiving systemic cancer therapy, in response to a service need. A robust evaluation of the pilot programme was undertaken, which found that defined clinical procedures traditionally undertaken in hospitals were safely undertaken in the patient's home with no adverse effects. There was a dramatic decrease in hospital attendances for these defined clinical procedures, and hospital capacity was consequently freed up. Patients valued having aspects of their care delivered at home and reported that it improved their quality of life, including reduced hospital visits and travel time. Community nurses expanded their scope of practice and became partners with oncology day-ward nurses in caring for these patients. Community nurses developed the competence and confidence to safely deliver cancer care in the community. This initiative shows that defined elements of acute cancer care can be safely delivered in the community so long as the training and support are provided. The findings and recommendations of the evaluation resulted in university accreditation and approval for national roll-out of the programme. Integration of services between primary and secondary care is a key priority. This innovative programme is a good example of shared integrated care that benefits both patients and health-care providers.
authors.affiliation: Nursing Development Co-ordinator, National Cancer Control Programme, Office of the Nursing and Midwifery Services Director, Health Service Executive, Ireland.
authors.forename: Terry
authors.initials: T
authors.lastname: Hanan
authors.forename: Louise
authors.initials: L
authors.lastname: Mullen
authors.forename: Marie
authors.initials: M
authors.lastname: Laffoy
authors.forename: Eve
authors.initials: E
authors.lastname: O'Toole
authors.forename: Janice
authors.initials: J
authors.lastname: Richmond
authors.forename: Mary
authors.initials: M
authors.lastname: Wynne
mesh_terms: D003152:Community Health Nursing / Q000458:organization & administration*; D003159:Community-Institutional Relations; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004059:Diffusion of Innovation; D004509:Education, Nursing, Continuing; D006801:Humans; D007494:Ireland; D009369:Neoplasms / Q000451:nursing*; D009859:Oncology Nursing / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care; D011788:Quality of Life
keywords: Community; Education; Nursing; Oncology