Background: This program illustrates the impact of contributions by nurse navigators to the development of a database influencing cancer care across the continuum. Oncology nurse navigation continues to grow in importance as nurses assist with the diverse needs of cancer patients. Demonstrating the impact of nurse navigation along the continuum of care not only supports better outcomes but allows for sustainment of a navigation program. An effective tool to document and measure accurate and timely interventions that is not labor intensive is critical.
Methods: A nurse navigation program piloted and tested several database programs starting with an Excel spreadsheet, which evolved to an ACCESS Database. Nurse navigators, nursing administration, and the IT research team developed a Web-based application. This application links existing systems within the institution, thus supporting clinical care. It also provides the ability to run reports allowing administrators to demonstrate the impact of navigation through the continuum of care and on the return on investment. All navigators utilize this application and actively participate in the continued upgrades and modifications meeting navigation program needs.
Results: By instituting this application, time and effort spent by the nurse navigator in documentation has decreased. This allows navigators to focus on patient needs while permitting accurate, timely, and effective documentation. Data collected and reported have helped sustain nurse navigators in breast cancer programs and provided support for proposals for additional navigators in gynecologic oncology, head and neck cancer, thoracic cancer, gastrointestinal cancer, and infusion room settings.
Conclusion: The database allows measurement of specific goals related to timeliness of patient care from initial call to first appointment and referral to clinical trials. The database assists with the evaluation of interdisciplinary metrics and goals across disease sites. The navigation database was developed by oncology nurse navigators to provide an avenue of documentation that is tailored to the needs of the oncology patient.
Oncology nursing practice includes patient education and advocacy. The evolution of the development of the navigation database demonstrates the impact that oncology nurses can have in creating a patient documentation tool while providing data that impact sustainability of this important role. Average retention rates across all disease sites is 68%. This information gleaned from the navigation database supports the nurse navigator role in our institution.
Information we are able to collect in the database demonstrates return on investment for patients touched by navigation and is reflected in retention rates, multidisciplinary care, clinical trial accruals, and streamlined timeliness of care.