Cancer-Oriented Comprehensive Nursing Services in Republic of Korea: Lessons from an Oncologist’s Perspective

Abstract

Background and objectives: As is well known, cancer patients require extensive medical attention as they undergo surgery, chemotherapy, radiotherapy, and supportive care. The importance of high-quality cancer-directed nursing, combined with precision medicine, to maximize their survival outcomes and help them achieve a better quality of life cannot be overemphasized. In this context, we offered a new cancer-oriented comprehensive nursing system to our inpatients and reviewed its clinical outcomes in comparison with those from the preexisting general cancer ward. Materials and Methods: From March 2019 to February 2020, a total of 102 cancer patients and 42 nurses were enrolled in this pilot study. We aimed to analyze their performance in three main categories: structure, process, and patient/nurse outcomes. Results: First, structural (nurse staffing and environment) upgrades were installed in the cancer-oriented comprehensive nursing ward, including an improved nurse-patient ratio (1:8 in the comprehensive ward as compared with 1:14 in the general ward), wider space between beds (1.5 m versus 1.0 m), fully automatic beds with fall prevention sensors, etc. Second, the nursing process was improved (missed care 0.1 event/month vs. 1.3 event/month). Third, both patient and nurse outcomes showed preferable results in the comprehensive ward. The patient satisfaction level was higher in the comprehensive nursing ward than in the general ward (willing to revisit: 91.7% and 78.4%, respectively; willing to recommend to others: 95.0% and 76.8%, respectively). Pressure ulcers, as a patient safety indicator, were also decreased (0.3 events/month vs. 0.8 events/month). However, the fall incidence was similar in both groups (1.6 events/month vs. 1.5 events/month). In terms of nurse outcomes, turnover intention was stabilized and nurses’ job satisfaction in the comprehensive ward was superior to that of their counterparts. Conclusions: Our study was a pilot study to demonstrate that cancer patient-oriented comprehensive nursing services can be helpful in improving the quality of cancer treatment and nurses’ job satisfaction. Continued interest in and efforts to improve nursing care delivery are also crucial in achieving and maintaining the best possible cancer patient care.