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Hong, Kim, and Tae: Nationwide Survey for Current Status of Cancer Centers in Korea
Original Article

Asian Oncology Nursing 2016; 16(4): 261-269.

Published online: 31 December 2016

DOI: https://doi.org/10.5388/aon.2016.16.4.261

Nationwide Survey for Current Status of Cancer Centers in Korea

Su Youn Hong1, Kwang Sung Kim1, Young Sook Tae2

1Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.

2College of Nursing, Kosin University, Busan, Korea.

Address reprint requests to: Kim, Kwang Sung. Catholic University, Seoul St. Mary's Hospital,505 Banpo-dong, Seocho-gu, Seoul 06591, Korea. Tel: +82-2-2258-2786, Fax: +82-2-2258-2780, bm.coor@catholic.ac.kr

Received 17 August 2016       Revised 6 November 2016       Accepted 22 November 2016

© 2016 Korean Oncology Nursing Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study to identify the current status of cancer centers in Korea in terms of organization ofhospital.

Methods

21 cancer centers, from regional cancer centers to the largest hospitals, were surveyed from October to November 2014. The questionnaire was developed by the board members of the Oncology Nursing Society.

Results

Centers specializing in cancer treatment were either cancer hospitals or centers affiliated with larger hospitals. 81% operated wards solely for cancer patients. The average number of beds was 354.2, and each center had independent laboratories, chemotherapy infusion rooms and pharmacies. Degree of nursing staff varied from grades 1 to 3. The nursing department and ward were jointly responsible for educating new nurses. In cancer nursing, the policy varied according to institution. For patient education, the oncology Advanced Practice Nurse (APN) mainly informed patients of the adverse effects of chemotherapy and central line care. 90.5% appointed oncology APNs, who were variously designated (47.6%). 10.5% of APNs held concurrent positions.

Conclusion

As cancer has increased medical professional organizations have shown a variety of forms of organization and human resources management. A political approach seems to be required for institutions for nursing care, patient education, the role and qualifications of APN.

Keywords: Cancer Center, Oncology Nursing

Figures and Tables

Table 1

Organization (N=21)

aon-16-261-i001
Variables Categories n (%) or M±SD
Organizational level Cancer canter 11 (52.4)
Cancer hospital 9 (42.8)
No division 1 (4.8)
Beds for cancer patients Yes 17 (81.0)
 Medical departments 5 (29.4)
 Organs body 4 (23.5)
 Treatment Modality 1 (5.9)
 Others 7 (41.2)
No 4 (19.0)
Number of beds 354.2±280.2
＜100 5 (29.4)
100~499 7 (41.2)
500~1,000 4 (23.5)
＞1,000 1 (5.9)
Available facility in the cancer center* Pharmacy 20 (95.2)
Outpatient clinics 18 (85.7)
Infusion room 18 (85.7)
Counseling room 16 (76.2)
Hospice unit 16 (76.2)
Short 11 (52.4)
Department of radiology 8 (38.1)
Laboratory 8 (38.1)
Others 1 (4.8)

*Duplicate check possible.

Table 2

Staffing of Oncology Nurses (N=21)

aon-16-261-i002
Variables Categories n (%) M±SD
Nursing staffing grades (nurse: patient ratio) Grade 1 (1.0:<2.0) 6 (28.6)
Grade 2 (1.0:2.0~2.5) 12 (57.1)
Grade 3 (1.0:2.5~3.0) 3 (14.3)
Nursing care delivery system Primary 7 (33.3)
Team 6 (28.6)
Both 7 (33.3)
Etc. 1 (4.8)
Educational period for orienteer (day) General orientation for new orienteer 14.4±10.5
Assigned nursing unit 48.5±33.7
Sub total 63.0±35.4
Educational subjects* (hr) Disease 3.7±2.7
Administration procedure 3.6±4.0
Side effects of chemo drugs 2.2±1.5
chemotherapy protocols 2.1±1.8
Safety of chemo drugs 1.9±1.3
Pain assessment 1.8±1.2
Infection controls 1.7±1.1
Medical equipment in service 1.6±1.0
Central venous catheter care 1.5±0.8
Radiation treatment 1.3±1.0
Etc. 2.9±3.1
Sub total 35.8±16.0

*Duplicate check possible; hr= hour; Etc.= Et cetera.

Table 3

Oncology Specific Nursing Care (N=21)

aon-16-261-i003
Categories n (%) M±SD
Reverse isolation*
 Masking 21 (100.0)
 Prohibition of flower 21 (100.0)
 Prohibition of visitor 21 (100.0)
 Private room 16 (76.2)
 Using separate medical device 14 (66.7)
 Sitz bath 12 (57.1)
 Gowning 11 (52.4)
 Disinfection of toothbrush 6 (28.6)
 Capping 5 (23.8)
Pain care
Standard tool for pain management 21 (100.0)
 Pain assessment factor- site, intensity, pattern, duration 21 (100.0)
 Pain managed by pharmacologic or non pharmacologic intervention 21 (100.0)
 After the intervention of the pain and underwent a re-evaluation provides additional interventions 21 (100.0)
 The daily pain assessment 20 (95.2)
 Approved by a committee 5 (23.8)
 Assess pain in only when the patient complained 2 (9.5)
Pain Scale*
 NRS 21 (100.0)
 FLACC 6 (28.6)
 FPRS 5 (23.8)
 VAS 2 (9.5)
 CRIES 2 (9.5)
Central venous catheter care done by*
 Intern 17 (54.8)
 APN (advanced practice nurse) 6 (19.4)
 Others 8 (25.8)
Central venous catheter dressing change (day)
 Gauze dressing 2.5±1.6
 Transparent dressing 5.8±2.0
Heparin locking care (day)
 Implanted chemo port 25.0±18.7
 Hickman broviac catheter 11.9±18.1
Emotional support program*
 Psychiatry consult 19 (45.2)
 Spiritual assistance 12 (28.6)
 General counseling 3 (7.1)
 Etc. 8 (19.0)
Patient education contents*
 Side effects of chemotherapy APN 16 (76.2)
Nurse 12 (57.1)
Others 3 (14.3)
 Side effects of radiation therapy APN 7 (33.3)
Nurse 12 (57.1)
Others 7 (33.3)
 Pain management APN 8 (38.1)
Nurse 17 (81.0)
Others 3 (14.3)
 Drain care APN 7 (33.3)
Nurse 15 (71.4)
Others 1 (4.8)
 Nutrition management APN 6 (28.6)
Nurse 8 (38.1)
Others 13 (61.9)
 Ostomy care APN 13 (61.9)
Nurse 9 (42.9)
Others 4 (19.0)
 Post-operative
 Site care		 APN 9 (42.9)
Nurse 14 (66.7)
Others 2 (9.5)
 Central venous catheter care APN 12 (57.1)
Nurse 14 (66.7)
Others 2 (9.5)
 Reverse isolation APN 7 (33.3)
Nurse 18 (85.7)
Others 3 (14.3)
 Etc. APN
Nurse 1 (4.8)
Others

*Duplicate check possible; APN= Advanced practice nurse; Etc.= Et cetera.

Table 4

Chemo Drugs Safety Protocol (N=21)

aon-16-261-i004
Variables Categories n (%)
Preparing place Pharmacy 21 (100.0)
Unit 0 (0.0)
Prepared chemo drugs* Pharmacists 21 (100.0)
Nurses 4 (19.0)
Interns 4 (19.0)
Others 2 (9.5)
Chemo drugs safety guidelines Receive a written consent from a patient or guidance. 21 (100.0)
Chemo drugs prescribed by a physician according to chemotherapy protocol 21 (100.0)
Using a safety spill kit when the chemo drugs spill 21 (100.0)
Educate patients and caregivers about side effects of the chemo drugs 21 (100.0)
Wear a personal protective equipment 21 (100.0)
Chemo drugs prescribed by written physician orders 20 (95.2)
Chemo drugs verified by 2 medical staffs prior to administration 20 (95.2)
Dr. orders reviewed prior to administration 20 (95.2)
Chemo drugs extravasation process guideline 19 (90.5)
Chemo drugs prescribed only attending physician 19 (90.5)
Chemo drugs prepared are not prepared at night time 18 (85.7)
Toxicity of chemo drugs evaluate regularly 17 (81.0)
Chemo drugs administered exclusively in oncology department 4 (19.0)
Personal protective equipment during chemotherapy Gloves 21 (100.0)
Mask 21 (100.0)
Gown 4 (19.1)

*Duplicate check possible.

Table 5

Qualification and Task of Oncology Advanced Nurse Practitioner (N=19)

aon-16-261-i005
Categories n (%)
Position APN 10 (52.6)
Staff nurse 7 (36.9)
Two concurrent positions 2 (10.5)
Title* APN 11 (52.4)
Fixed oncology nurse 6 (28.6)
Coordinator 3 (14.3)
Physician assistant 1 (4.8)
Qualifications Education Master degree 11 (57.9)
No specification 8 (42.1)
Career No specification 11 (57.9)
Experienced 8 (42.1)
Certified Certification of oncology APN 11 (57.9)
Non certification 8 (42.1)
Sub ordinate* Nursing department 15 (71.4)
Non nursing department 4 (19.0)
Etc. 2 (9.5)
Oncology ANP committee None 14 (73.7)
Yes 5 (26.3)
Incentives None 14 (73.7)
Yes 5 (26.3)
Professional nursing practice Verifying the medication 19 (100.0)
Management of complications 19 (100.0)
Coordinating and reviewing treatment plan 18 (94.7)
Drug infusing 18 (94.7)
Physical assessment and evaluation 17 (89.5)
Pain management 17 (89.5)
Central venous catheter care 16 (84.2)
Lab. data review 16 (84.2)
Discharge education 15 (78.9)
Medical rounding 14 (73.7)
Ostomy care 10 (52.6)
Drawing blood 3 (15.8)
Etc. 3 (15.8)
Delegation role Take a consent 14 (73.7)
Wound and drainage care 13 (68.4)
Prescription drugs 8 (42.1)
Recording medical documents 7 (36.8)
Preliminary physical assessment for a new patient 7 (36.8)
Issuing medical documents 3 (15.8)
Invasive treatment 3 (15.8)
Education and counseling Producing education material 19 (100.0)
Patient and family education 19 (100.0)
Symptom education and counselling 19 (100.0)
Education for the staff nurse 18 (94.7)
Research Nursing research and consultation 17 (89.5)
Participation in multidisciplinary studies 15 (78.9)
Data management 14 (73.7)
Consultation and coordination Consultation for nurses 19 (100.0)
Consultation and referring for other department 17 (89.5)
Notify treatment process 15 (78.9)
Referring to other institution 14 (73.7)
Interdisciplinary team care 13 (68.4)
Leadership Joining the professional organization 18 (94.7)
Developing cancer nursing standard 15 (78.9)
Participate in relevant department meeting 15 (78.9)
Provide information to be developed insurance fee 15 (78.9)
Event planning and support for cancer patients 13 (68.4)
Developing printed material and website 9 (47.4)
Advising survivor group 8 (42.1)

*Duplicate check possible; APN= Advanced practice nurse; Etc.= Et cetera.

Notes

This paper was supported by research funds of Korean Oncology Nursing Society in 2015.

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