Introduction: Goal and Objectives of the Study
Strategic plans for change always have a defined course of action that must be followed to achieve the goal quickly and successfully. In the case of oncology nursing practice, the problem of inadequate skills can become critical in the delivery of care and significantly affect the outcome of treatment.
Clinical Problem
Nurses’ Opinion
In oncology nursing practice, qualifications play an essential role. Support for cancer patients is necessary based on the ethical and professional principles of medicine (Zendeh et al., 2022 ). Nurses reason that cancer is a debilitating disease that requires substantial psychological support for the patient. Nurses acknowledge that various problems cause them to question their actions. They stated that their care might have been superficial and not achieved high results (Zheng et al., 2021). Anxiety about one’s qualifications is common among nurses in general.
Perception of Obstacles
Nurses may perceive the challenges of care in different ways. However, many report concerns about the need to provide specifically specialized care to cancer patients (Othman et al., 2021). Nurses are concerned that the nursing process remains unrecognized in the community because neither patients nor their families see the value in typical nursing practices (Blaževičienė et al., 2017). The value of nurses has been proven for timely hospitalization and cancer diagnosis (Othman et al., 2021). The inability to provide informational support is a barrier for nurses.
Implications
The nurse specialist is a staffing category that is in short supply (Nwozichi et al., 2017). The problem of understaffing with high turnover is common in many organizations, but this situation is critical for health care. It leads to patient-provider conflicts (Blaževičienė et al., 2017), inadequate and untimely care (Zheng et al., 2021), and poorly qualified care (Nwozichi et al., 2017). With the severity of the specific nature of the disease and the emotional strain, inexperienced nurses fail to perform their tasks because they are not adequately trained (Zheng et al., 2021).
Strategic Plan for Change
Review
The plan is based on research that has a high rate of change. Cassidy et al. (2021) indicate that manual adaptation can be a critical component of implementation as organizations’ internal policies vary. In addition, the authors suggest that these policies should be changed along with the implementation of training to support nurses. It will make them more comfortable and willing to pursue new care paths (Cassidy et al., 2021). Combining multiple ways to implement the guidelines will also be more effective than using only one pathway.
Implementation Pathway
In the current implementation pathway plan, each element is critical to set the stage for aspirations for change. The implementation pathways will be based on conducting three elements of change.
Educational meetings are needed to raise actual awareness among nurses about cancer care. Distributing materials is a way to keep teams energized, and access to them will give them confidence in their abilities. Finally, organizational policy change is critical in overcoming barriers (Cassidy et al., 2021). It will track learning outcomes, improve the business culture, and promote cooperation within the team.
The Theoretical Model and Overcoming Barriers
A COM-B model is a tool that identifies ways to change staff behavior when influenced by the model’s three components. The theoretical aspects of the model allow change strategies to be organized according to desired outcomes (McDonagh et al., 2018). COM-B is an evidence-based practice in health care that normalizes the need for change and develops a commitment to meeting high standards of care. Using all the components and gradually expanding the practices in each direction will change professional behavioral patterns.
In oncology practices, implementing change is particularly difficult because the context of working with oncology patients forces skepticism about new leadership. Staff-level changes will be better received if change leaders can justify their necessity to opponents (Cassidy et al., 2021). Nurses need to have checkpoints by which to see that their training has borne fruit. Supervisors need to learn how to communicate with staff and identify the reasons why change is causing fear. Finding staff as faculty is a complex problem, and it is worth going directly to universities to ask for support.
Tracking and Evaluating Change
To track the post-change experience promptly, tools should be used to determine the effectiveness and observed improvements. Sources of internal evidence are the data that can establish whether improvement has occurred and in what areas. It is essential to determine how patients’ behavior has changed: how often they report spiritual improvement, what symptoms have been alleviated, and how care has helped them. The administrative process is essential: data should be collected on the frequency of attendance at educational meetings. The financial aspect needs attention, but it is vital to establish which metrics are directly related to change: the number of resources spent.
Methods for assessing the implementation of change are a group of methods that establish the magnitude of the outcome achieved. They are based on either qualitative or quantitative indicators. Qualitative evaluation methods determine how nurses behave after implementing training practices, and quantitative methods determine how often new knowledge is used. The most effective methods would be tests and participation – determining the frequency and quality of new skills and evidence of educational courses taken. The observation method will establish how nurses’ behavioral characteristics have changed after introducing new educational practices. Performance measures will determine the number of bed days patients spend with the new nursing technology.
Ethical Considerations
Ethical considerations are essential to any change strategy, especially in implementing new care guidelines. Ethical considerations can drive the implementation problems that arise if the changes have adverse patient outcomes. They can be solved if there is appropriate supervision of the activities of the responsible managers and trainers (Othman et al., 2021). The field of change involves individuals diagnosed with cancer; it should be responsibly ensured that everyone involved is aware of the potential risks. Risk notification should occur in writing with anonymity and a guarantee of confidentiality when the results of implementing the change are published.
Conclusions
The clinical problem of low nurse awareness in oncology practice can lead to inappropriate care. It arises from a lack of qualifications, distrust on the part of patients, and a lack of communication skills. Changes should focus on implementing educational meetings, distributing materials, and changing organizational policies. The COM-B is recommended because it has proven effectiveness. Sources of internal evidence: objective data from patients, administrative procedures, finance department, communication management, and nurses’ experiences after changes.
References
Blaževičienė, A., Newland, J.A., Čivinskienė, V., & Beckstrand, R. L. (2017). Oncology nurses’ perceptions of obstacles and role at the end-of-life care: cross sectional survey. BMC Palliative Care, 16(74).
Cassidy, C.E., Harrison, M.B., Godfrey, C, Nincic, V., Khan, P. A., Oakley, P., Ross-White, A., Grantmyre, H., & Graham, I. D. (2021). Use and effects of implementation strategies for practice guidelines in nursing: A systematic review. Implementation Science, 16(102).
McDonagh, L. K., Saunders, J. M., Cassell, J., Curtis, T., Bastaki, H., Hartney, T., & Rait, G. (2018). Application of the COM-B model to barriers and facilitators to chlamydia testing in general practice for young people and primary care practitioners: A systematic review. Implementation Science, 13(130).
Nwozichi, C. U., Ojewole, F., & Oluwatosin, A. O. (2017). Understanding the challenges of providing holistic oncology nursing care in Nigeria. Asia-Pacific Journal Of Oncology Nursing, 4(1), 18-22. Web.
Othman, E. H., Alosta, M. R., Alasad, A. J., & Al Muhaisen, S. (2021) Nursing diagnoses among oncology patients in medical units: A retrospective study of patients’ records. Ecancer, 15(1315).
Zendeh, M. B., Maslakpak, M. H., & Jasemi, M. (2022). Nurses’ perceptions of their supportive role for cancer patients: A qualitative study. Nursing Open, 9, 646-654.
Zheng, R., Guo, Q., Chen, Z., Ma, L., & McClement, S. (2021). An exploration of the challenges for oncology nurses in providing hospice care in mainland China: A qualitative study. Asia-Pacific Journal Of Oncology Nursing, 8(2), 139–146. Web.