క్యాన్సర్ సర్జరీ

నైరూప్య

Innovations in Cancer Care Delivery

Naseem Yusaf

Cancer is a major health problem worldwide and a significant cause of morbidity and mortality in all age groups. The incidence rate of cancer is increasing worryingly as, in a lifetime; almost ½ of the population will be diagnosed with cancer (Cullen, & Rew, 2013). This disease demands specialized and usually aggressive medical treatment as well as skilled nursing management (Yarbro, Wujcik, & Gobel, 2011). Regardless of the advancements in medical technology, diagnostic approaches, and treatment modalities, the morbidity and mortality related to the cancer is on unceasing increase (Briscoe, 2013). There are numerous innovative cancer therapies comprising gene therapy, immunotherapy, hormone replacement therapy, targeted drug delivery systems, laser therapy, application of nanotechnology, RNA interference therapy, photosensitizer and hyperthermia, and cancer vaccines (Vunnava, 2015). These therapies are aimed to improve the effectiveness of the treatment by minimizing the side effects and increasing efficacy. Besides significant improvement in the speed and accuracy of cancer diagnosis and the effectiveness of treatment, there is lot more to be done as management of consequent side effects remains a challenge for oncology nurses (Aapro, Astier, Audisio, Banks, Bedossa, Brain, Cameron, Casali, Chiti, De Mattos-Arruda, and Kelly, 2017). Objectives This presentation includes elaboration of the need for innovation and creativity in cancer care delivery, discussion on innovative strategies to improve the effectiveness of nursing care and the challenges in creating innovations in oncology nursing care delivery. The Need for Innovation Facing the disease is a challenge not only for the patients but for the Oncology Nurses as well. Undeniably, the innovations in cancer diagnosis and treatment have brought hope to the patients, but, at the same time, the emerging challenges as changing healthcare systems, aging population around the globe, increased disease burden, competing economic interest, and scarcity of services have posed multiple obstacles as a challenge to get the best outcome of the care provided and to make the best use of the skilled workforce (Aranda, 2018). Therefore, there is a dire need to provide advanced and innovative care to the cancer patients in order to meet the demands imposed by the dynamic and complex nature of disease and its management, and the devastating effects of the diagnosis of cancer on the patients and their families. Cancer patients by the nature of their diseases have differing potentials for prevention, screening and early detection. The diagnostic approaches are different, as are the patterns of spread, responses to therapy and rehabilitation needs. The need exists for acute, long term and palliative care for patients whose disease is no longer responsive to curative treatment. The Oncology Nurse, as a key member of multidisciplinary team, has a responsibility to ensure that the patient in their care receives the highest standard of evidenced- based nursing care (Yarbro, Wujcik, & Gobel, 2011). Furthermore, Oncology Nurses as frontline care providers are indebted to create innovations in cancer care delivery so as to reciprocate the undercurrents of medical management and the evolving factors. Innovative Care approach This part of the presentation will discuss the measures used to improve the effectiveness of the care provided including but not limited to the: • Development of support roles including role as a Clinical Nurse Specialist and non-clinical support roles • Complementary therapies (Aromasticks, Acupuncture, Herbs, Relaxation Therapy, Reflexology, Homeopathy) • Transitions in healthcare delivery (Inpatient to outpatient, Infusions to oral) • Use of tools, frameworks, models of healthcare delivery and care pathways • Use of Information System • Telehealth services / Hospital at home Challenges in creating innovations Lots of discoveries have been exploded in the diagnostic approaches and medical management of cancer. However, the literature explicating the innovations in nursing care delivery is scarce and there is growing realization among oncology nurses about the necessity to introduce diverse approaches in care delivery (Aranda, 2018). This part of the presentation will elaborate the challenges oncology nurses face in bringing innovation in cancer care delivery. The first and the foremost challenge is creating the space for nursing research. Nursing research is critical in the profession as it provides the basis for high quality evidence-based care. Despite widespread promotion of evidence-based practice, there is much room for improvement in nursing research tradition. Nurses should strive to enhance their motivation and engagement in the care improvement measures mainly through clinical trials to test the measures for instance management of chemotherapy or radiotherapy side effects, or enhancing recovery after a surgical procedure (Morgan, 2015). Further, there is need to create strong leadership in nursing that welcomes innovation and creativity and supports the change in the method of care delivery. Nursing leaders need to build a culture which is open to new ideas and critique of the current practice. Secondly, the leaders are in strong position to drive the quality of clinical practice,