(11) From cancer cautious to chemo confident: Building a pediatric oncology program at a new medical center

Title: From cancer cautious to chemo confident: Building a pediatric oncology program at a new medical center

Abstract : At a new pediatric hospital, without subspecialty units, nurses cared for various patient populations, including oncology. Nurses reported feeling unprepared despite access to a chemotherapy and biotherapy provider program. Robust orientation is essential for nursing satisfaction, retention, and, ultimately, patient outcomes. To address the identified gap, the project team designed and implemented an evidence-based pediatric oncology nurse orientation program.

This quality improvement (QI) project aimed to improve nurse preparation in the medical-surgical unit by implementing a structured pediatric oncology orientation program in a newly established pediatric hospital.

On the medical-surgical unit that cares for all pediatric patients who do not require intensive care, a QI project based on the Plan-Do-Study-Act (PDSA) method was initiated. P: Orientation was redesigned to include support for nurses without prior oncology experience. The program included intentional preceptor selection and the creation of the Chemo Champions Committee. D: After completing general unit orientation, nurses began the pediatric oncology orientation program. Nurses were paired with an experienced preceptor. The Chemo Champions standardized oncology orientation and were an on-unit resource. S: To evaluate outcomes, nurses completed a post-survey evaluating their experience. A: Ongoing use of the pediatric oncology orientation program, including guidance from the Chemo Champions, was required to sustain the project.

Only 22% of nurses reported being satisfied with orientation. Despite this, many nurses found the Chemo Champions valuable (44%), and most felt comfortable asking for support when caring for oncology patients (88%). Qualitative responses highlighted positive feedback and options for program improvement, such as infusion clinic training and more medication education, respectively. Since the program’s start in 2023, 15 nurses have completed the program, and only one has left the organization. Implications for pediatric oncology nursing include the use of innovative strategies to support nurses who are caring for pediatric oncology patients outside of specialty units.