[Introducing clinical nurse specialists (CNS) in the ambulatory setting: the experience of a Research Cancer Center in Italy.]

Abstract

. Introducing clinical nurse specialists (CNS) in the ambulatory setting: the experience of a Research Cancer Center in Italy.

Introduction: In 2018 the role of clinical nurse specialist (CNS) was implemented in an ambulatory setting at our cancer institute.

Objectives: To describe the CNS role implementation and the indicators to measure and the impact of the CNS after one year.

Methods: Indicators for the implementation: CNS interface mapping in disease pathways, participation in multidisciplinary team (MDT) meetings, and number of training hours per CNS on specific cancers. Indicators for the impact: patient satisfaction with CNS (survey), compliance with for waiting times for the first visit, number of documented CNS-patient communications and number of improvement projects in which CNSs were involved.

Results: One year after CNS introduction, pathway mapping was 100%; MDT meeting participation 95%; training hours 40.5/CNS vs. standard 30 hours; 83.2% of interviewed patients were very satisfied with CNSs. On average 27 face to face and 126 phone interviews per month were performed. The number of first visits increased of 13% componed to the previous year.

Conclusions: CNSs were successfully introduced into disease pathways and played an active role in the MDTs. The positive impact observed suggests that this new role could represent a response to the need to design patient centered services for cancer diseases. Measuring the CNSs activities and their impact on the patient outcomes and on system efficiency is the key for defining nursing staffing standards in the disease pathways, tailored on patients and organization characteristics.