Breast Nurse Navigation Impacts Timeliness of Care for Breast Cancer Patients
Loril Garrett, BSN, RN, OCN, CBPN-IC, CBCN (Spectrum Health); Geralyn Roobol, RN, BS, LMSW, CMAC (Spectrum Health); Susan Dunn, PhD, RN
Breast cancer care is often delivered by multiple health care providers over an extended period of time within an already fragmented health care system. This can result in persistent gaps in the care process leading to inadequate follow-up and delays in treatment. The breast nurse navigator (BNN) role seeks to address these shortcomings by bridging the gaps and therefore assists with improving patient outcomes in the process. Some BNN programs have demonstrated improvements in timeliness of access to care, resolution of barriers to care, and heightened patient satisfaction. The purpose of this retrospective descriptive study was to examine the impact of the BNN on timeliness of care throughout a breast cancer patient’s treatment trajectory. Hildegard Peplau’s Interpersonal Relations Model of Nursing was utilized for this study as it highlights the effectiveness of the therapeutic nurse-patient relationship on reaching mutual problem-solving goals, providing for optimal patient outcomes. The study was conducted at a large health care institution in West Michigan, comparing 423 patients who received care prior to the initiation of the BNN program (fiscal year 2009) compared with 170 patients who received BNN services during the initial year of the program (fiscal year 2010), and with 82 patients who received BNN services in fiscal year 2011. Data was collected from the institution’s cancer registry and the patients’ medical records by nursing students. SPSS statistical software was used for data analysis. Analysis of variance tests showed significant improvements in timeliness of care from 2009 (pre-BNN program initiation) to 2010 (first year of BNN program) and from 2010 (first year of BNN) to 2011 (year two of BNN program). Potential limitations include data collection from only one health care institution and limited demographic information available for analysis. Findings validate the role of the BNN in removing barriers to care, potentially improving patient outcomes and the overall quality of health care delivery. Study results support the implementation of BNN programs nationwide. Further research should be done with a variety of BNN programs across the nation and should be further conducted to support the expansion of nurse navigation to a variety of cancer diagnoses.
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