Oncology clinical trials nursing: developing competencies for the novice

Oncology clinical trials are important in the improvement of outcomes for people with or at risk for cancer. Because of the complexity of oncology clinical trials and the needs of patients with cancer, nurses play a crucial and unique role in the trial setting. However, great variability exists in how the role of the nurse on a research team is defined and implemented. An Oncology Nursing Society project team set out to identify the core competencies required of a novice oncology clinical trials nurse (CTN) across diverse settings. This article describes the process used to develop core competencies for the novice CTN, presents the final core competencies, and offers examples of how those competencies might be used in practice.

Implementing a geriatric assessment in cooperative group clinical cancer trials: CALGB 360401

PURPOSE

Factors captured in a geriatric assessment can predict morbidity and mortality in older adults, but are not routinely measured in cancer clinical trials. This study evaluated the implementation of a geriatric assessment tool in the cooperative group setting.

PATIENTS AND METHODS

Patients age ≥ 65 with cancer, who enrolled on cooperative group cancer trials, were eligible to enroll on Cancer and Leukemia Group B (CALGB) 360401. They completed a geriatric assessment tool before initiation of protocol therapy, consisting of valid and reliable geriatric assessment measures which are primarily self-administered and require minimal resources and time by healthcare providers. The assessment measures functional status, comorbidity, cognitive function, psychological state, social support, and nutritional status. The protocol specified criteria for incorporation of the tool in future cooperative group trials was based on the time to completion and percent of patients who could complete their portion without assistance. Patient satisfaction with the tool was captured.

RESULTS

Of the 93 patients who enrolled in this study, five (5%) met criteria for cognitive impairment and three did not complete the cognitive screen, leaving 85 assessable patients (median age, 72 years). The median time to complete the geriatric assessment tool was 22 minutes, 87% of patients (n = 74) completed their portion without assistance, 92% (n = 78) were satisfied with the questionnaire length, 95% (n = 81) reported no difficult questions, and 96% (n = 82) reported no upsetting questions. One hundred percent of health care professionals completed their portion.

CONCLUSION

This brief, primarily self-administered geriatric assessment tool met the protocol specified criteria for inclusion in future cooperative group clinical trials.

Outpatient instruction for individuals with COPD

Educating individuals with COPD is an important part of their overall medical and nursing management. Due to the debilitating nature of the disease, care must be exercised to offer programs that meet the participants' individual needs. Classes should be offered at a convenient time and place. To facilitate discussion, class size should be kept small. Family members and significant others should be encouraged to attend the classes to reinforce what is taught in class and to provide support and encouragement. Finally, measuring outcomes is important in order to demonstrate the overall effectiveness of the program; however, instruments used to measure effectiveness must be simple, easy to administer, and complete. Helping individuals manage their COPD presents a real challenge to nurses. A well-designed educational program is one cost-effective measure that can meet this challenge.