Keywords

Cancer care, Evidence-based practice, Implementation strategies, Infection control, Medication adherence, Oncology nursing, Palliative care, Pain, Psychosocial assessment, Quality improvement

Authors

1. Cooley, Mary E. PhD, RN, FAAN
2. Biedrzycki, Barbara PhD, CRNP, AOCNP
3. Brant, Jeannine M. PhD, APRN, AOCN, FAAN
4. Hammer, Marilyn J. PhD, DC, RN, FAAN
5. Lally, Robin M. PhD, MS, BA, RN, AOCN, FAAN
6. Tucker, Sharon PhD, APRN-CNS, NC-BC, FNAP, FAAN
7. Ginex, Pamela K. EdD, MPH, RN, OCN

Abstract

Background: Adoption of evidence remains slow, leading to variations in practices and quality of care. Examining evidence-based interventions implemented within oncology settings can guide knowledge translation efforts.

Objective: This integrative review aimed to (1) identify topics implemented for oncology-related evidence-based practice (EBP) change; (2) describe frameworks, guidelines, and implementation strategies used to guide change; and (3) evaluate project quality.

Methods: PubMed and CINAHL were searched to identify published practice change projects. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. Fifty articles met the inclusion criteria. Data were extracted; content analysis was conducted. The Quality Improvement Minimum Quality Criteria Set guided quality assessment.

Results: Topics included infection control/prevention (n = 18), pain/palliative care (n = 13), psychosocial assessment (n = 11), and medication adherence (n = 8). Among the projects, Plan, Do, Study, Act (n = 8) and Lean Six Sigma (n = 6) frameworks were used most. Thirty-six projects identified guidelines that directed interventions. Multiple implementation strategies were reported in all articles with planning, education, and restructuring the most common. Reach, sustainability, and ability to be replicated were identified as quality gaps across projects.

Conclusion: The EBP topics that emerged are consistent with the oncology nursing priorities, including facilitating integration of EBP into practice. The studies identified used national guidelines and implementation strategies to move evidence into practice. Heterogeneity in measurement made synthesis of findings difficult across studies, although individual studies showed improvement in patient outcomes.

Implications for Practice: Development of an interprofessional oncology consortium could facilitate a standardized approach to implementation of high-priority topics that target improved patient outcomes, harmonize measures, and accelerate translation of evidence into practice.