Creating and validating an instrument to identify the workload at an oncology and hematology outpatient service

Martin, Lelia Gonçalves Rocha; Gaidzinski, Raquel Rapone

doi:10.1590/S1679-45082014AO2996

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ORIGINAL ARTICLE • Einstein (São Paulo) 12 (3) • Jul-Sep 2014 • https://doi.org/10.1590/S1679-45082014AO2996 copy

Creating and validating an instrument to identify the workload at an oncology and hematology outpatient service

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

Construct and to validate an instrument for measuring the time spent by nursing staff in the interventions/activities in Outpatient Oncology and Hematology, interventions based on Nursing Interventions Classification (NIC), for key areas of Pediatric Oncology and Oncology Nursing.

Methods

Cross-sectional study divided into two steps: (1) construction of an instrument to measure the interventions/Nursing activities and (2) validation of this instrument.

Results

We selected 32 essential interventions from NIC for Pediatric Oncology and Oncology Nursing areas. The judges agreed with removing 13 and including 6 interventions in the instrument, beyond personal activity.

Conclusion

The choice of essential interventions from NIC is justified by the gain time on research.

Workload; Oncology Service, Hospital; Oncologic nursing; Personnel Downsizing

Domain 1. Physiological: Basic. Care that supports physical functioning
Class B urinary output management: interventions to establish and maintain regular bowel and urinary voiding patterns and to manage complications due to altered patterns
Intervention: 0590 Urinary output control
Definition: maintaining an excellent urinary output pattern
Is this a representative intervention in terms of the Nursing work conducted at an Oncology and Hematology Outpatient Service?__1 ⎕ No__ 2 ⎕ Yes
Is mapping this NIC intervention relevant?__1 ⎕ No__ 2 ⎕ Yes
Would you remove this intervention?__1 ⎕ No__ 2 ⎕ Yes
Would you include any other intervention?__⎕ No__ ⎕ Yes, Which one?
Intervention: ________________________________________________

Code	Mapped Interventions	Definitions
8190	Telephone follow-up	Providing results of tests, evaluating patient’s response and determining potential for problems as a result of previous treatment, examination or testing, over the telephone
2210	Analgesic administration	Use of pharmacologic agents to reduce or eliminate pain
4030	Blood products administration	Administration of blood or blood products and monitoring of patient’s reactions
2313	Medication administration: intramuscular	Preparing and giving medications via the intramuscular route
2304	Medication administration: oral	Preparing and giving medications by mouth
2314	Medication administration: intravenous (IV)	Preparing and giving medications via the intravenous route
7040	Caregiver support	Provision of the necessary information, advocacy and support to facilitate primary patient care by someone other than a healthcare professional
5420	Spiritual support	Assisting the patient to feel balance and connection with a greater power
4430	Therapeutic play	Purposeful and directive use of toys or other materials to assist children in communicating their perception and knowledge of their world and to help in gaining mastery of their environment.
1400	Pain management	Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient
0590	Urinary output control	Maintaining an excellent urinary output pattern
1450	Nausea management	Prevention and alleviation of nausea
1100	Nutrition management	Providing and promoting a balanced intake of nutrients and fluids
2240	Chemotherapy management	Assisting the patient and family members to understand the action and minimize side effects of antineoplastic agents
6540	Infection control	Minimizing the acquisition and transmission of infectious agents
2380	Medication management	Facilitating safe and effective use of prescription and over-the-counter drugs
6482	Environmental management: comfort	Manipulation of the patient’s surroundings for promotion of optimal comfort
1570	Vomiting management	Prevention and alleviation of vomiting
4120	Fluid management	Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels
2080	Fluid/Electrolyte management	Regulation and prevention of complications from altered fluid and/or electrolyte levels
5230	Coping enhancement	Assisting a patient to adapt to perceived stressors, changes, or threats which interfere with meeting life demands and roles.
5566	Parent education: childrearing family	Assisting parents to understand and promote the physical, psychological, and social growth and development of their toddler, preschool, or school-aged child/children
4235	Phlebotomy: cannulated vessel	Aspirating a blood sample through an indwelling vascular catheter for laboratory tests
5820	Anxiety reduction	Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source of anticipated danger
5880	Calming technique	Reducing anxiety in patient experiencing acute distress
4200	Intravenous therapy (IV)	Administration and monitoring of intravenous fluids and medications
3740	Fever treatment	Management of a patient with hyperpyrexia caused by non-environmental factors

Characteristics	n (%)
Sex
Female	5 (83.3)
Male	1 (16.7)
Age
≥30 years	6 (100.0)
Occupation
Professor	3 (50.0)
Nursing Manager	1 (16.7)
Senior Nurse	1 (16.7)
Nursing Technician	1 (16.7)
Highest Degree
PhD	2 (33.3)
Master	2 (33.3)
Specialist	1 (16.7)
Nursing Degree	1 (16.7)
Years of experience since graduation (average)
<1	1 (16.7)
≥ 5-10	1 (16.7)
≥10	4 (66.7)
Average total years of experience in Oncology
0	2 (33.3)
7	1 (16.7)
10	1 (16.7)
12	1 (16.7)
15	1 (16.7)
Average total years of experience in NIC
0	1 (16.7)
<1	2 (33.3)
6	1 (16.7)
7	2 (33.3)

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[1] Corresponding author: Lelia Gonçalves Rocha Martin – Avenida Paulista, 37, 15th floor – Bela Vista – Zip code: 01311-902 − São Paulo, SP, Brazil – Phone: (55 11) 2151-5134 − E-mail: martin.lel@gmail.com