Providing the Best Cancer Care Through Oncology Nursing Excellence: the de Souza Model

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1 Providing the Best Cancer Care Through Oncology Nursing Excellence: the de Souza Model Dr. Mary Jane Esplen Director, de Souza Institute Professor and Clinician- Scientist, University of Toronto/ University Health Network

2 What is de Souza Institute? Created in 2008, de Souza Institute provides ongoing educational support, professional development and career counseling to nurses caring for cancer patients and families. Using telemedicine, online learning, innovative technologies and live events, the Institute provides education to nurses in their communities. A not-for-profit organization offering nurses working in the home, clinic or hospital access to the latest best practices and information at no cost. Created in 2008, de Souza Institute provides ongoing

3 Cancer is on the Rise Every day 500 Canadians are diagnosed with cancer and 200 die from the disease. *Canadian Cancer Society

4 Building Nursing Knowledge Capacity Across the Cancer Journey (CCO) Cancer Care Ontario- overall approach to building a quality system Recognizes important and unique contributions of oncology nurses across the system Safe, effective care across the cancer journey Risk Factors & Prevention (Cancer Prevention) Screening (Genetics) Diagnosis (Oncology Foundation) Treatment (Chemo/ Biotherapy course) QUALITY, ACCOUNTABILITY, INNOVATION Recovery (Survivorship) Palliative & End-of-Life Care (Palliative Care)

5 Our Vision and Mission Vision To be the world leader in oncology nursing excellence and innovation. Mission To inspire and empower nurses through education and mentorship to provide the best cancer care.

6 Beyond the Tumor Psychosocial (emotional) and existential concerns Process of cancer diagnosis, treatment, recovery and survivorship has inevitable psychosocial consequences Evidence exists for significant psychosocial distress at all stages of cancer for individuals and their families

7 de Souza Institute Achievements ü Reached over 5000 nurses ü Created 27 courses, with 4 more in development ü Developed a state-of-the-art integrated, innovative approach ü Almost 80% increase in the number of nurses in Ontario ü ü Created 27 courses, with 4 more in development ü

8 de Souza Institute Achievements ü University of Windsor partnered with de Souza Institute to offer graduate diploma program in Advanced Practice Oncology/ Palliative Care. ü Patients experiencing the de Souza difference through de Souza Designates. ü Other provinces- positive feedback on Alberta pilot that sponsored 10 nurses in study groups through online learning. ü Nurses in the Kuwait Cancer Control Centre received on site delivered de Souza courses. ü Work with cancer leaders in Brazil to improve national oncology certification success among nurses.

9 Experiencing the de Souza Difference

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11 Accessibility and Technology

12 Knowledge Transfer

13 Certification Support for Canadian Specialty Exams (CNA and CPHON ) Study groups (elearning) CNA Oncology Nursing CNA Hospice Palliative Care Nursing CPHON (Certified Pediatric Hematology Oncology Nurse-exam in USA)

14 Current Courses Designation Course Offerings (Obtain a minimum of 4.0 credits and complete at least 1 course in each of the 4 categories.) Treatment & Delivery of Evidence Based Care Therapeutic & Supportive Relationships Developing Professional Practice & Leadership Patient Teaching & Coaching Radiation Oncology (0.5) Psychosocial Care Education Workshop (0.25) Advanced Oncology Nursing Leadership Course (1.0) Cancer Prevention (0.5) Foundations in Oncology Nursing (0.75) Managing Grief & Loss (0.25) Care for the Professional Caregivers (0.25) ehealth Nursing & Oncology (0.25) Patient Education (TBD) Chemotherapy & Biotherapy Provincial Standardized Course (1.0) Advance Care Planning (0.25) Critical Thinking course (0.25) Patient Navigation (0.5) Pain & Symptom management Course (0.25); Advanced Pain Assessment & Management (0.5) Interdisciplinary Psychosocial Oncology Distance Education (PODE) courses: Interprofessional Psychosocial Oncology: Introduction to Theory & Practice (1.0) Sexual Health & Cancer Part 1 (0.5), Part 2 (0.5) Relational Practices with Families in Oncology & Palliative Care (1.0) Facilitator courses EPEC-O (1.0) Learn to lead psychosocial care (1.0) Chemotherapy Facilitator (1.0) Pediatric Workshop: What s in a word? (0.25) Palliative workshops Palliative Care in Pediatric Oncology (TBD); Foundations in Pediatric Oncology (TBD) Therapeutic Communication (TBD) Engagement with e-mentorship Program (0.25 & 0.5 credit programs) - Max 1.0 credits *BOLD are offerings that are coming soon Survivorship (TBD) Summer Institute : Health Clinical Research (1.0) Non credit courses: Oncology study group, Hospice Palliative Care study group; Certified Pediatric Hematology Oncology Nurse study group

15 Courses to Build Capacity Facilitator Series of Clinical leaders for champions/site experts Chemotherapy/biotherapy program Patient education program Psychosocial care education program Palliative Care/End of life education program

16 de Souza Designation * Standard recognized by employers and the public

17 de Souza Designation New recognized Brand and Standard Life-long learning Across the Cancer Care Continuum EvidenceBased practice & interpersonal approach

18 Virtual Library Free access to key journals and ebooks relevant for nursing, psychosocial oncology; oncology, prevention and health promotion etc. based on input from nurses, educators etc. Databases including: CINAHL from EBSCO ProQuest Nursing & Allied Health ERIC Cochrane

19 ementorship Program Built upon e-mentorship program created for Oncology Advanced Practice Nurses Career Development Work-life balance/self care Clinical/Practice Issues

20 Graduate Level Scholarships Annual peer reviewed competition Master s level education Doctorate level education

21 Highlights Oncology Foundations Course: for nurses working in general hospitals, communities, new nurses Introductory course to oncology nursing principles Demonstrate nursing role across cancer care trajectory Mode of Learning: elearning, self directed Participation to date: 1361 enrolled and 279 completed Education Work setting % cancer pts among all pts seen each day RN (degree): RN(diploma): RPN: Other (Students): 47% 29% 11% 13% Community (inc homecare): General Hosp: Cancer ctr: Other: 34% 30% 25% 10% Ca pts < a quarter ~ A third: > half: All cancer pts: 32% 19% 28% 20%

22 Highlights (cont d) Provincial Standardized Chemotherapy and Biotherapy Course: for nurses working in Cancer Centres Support patient safety and promotes quality of care Integrate Cancer Care Ontario recommendations/guidelines Facilitator course: building capacity across ON Mode of Learning: videoconferencing (day 1, 2) + in person (day 3) Participation to date: >1216 nurses from all 14 LHINs Learners in Standardized Course - de Souza educator Led (n) Learners in Standardized Course - Local facilitator led (n) Local Facilitator (n)

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24 Future Direction de Souza Foundation Brazilian Ball Sept 2012 Continuous improvement of standards and educational programs National and international partners Further graduate education development de Souza Nurse a standard for Oncology nursing excellence marketing External funding for research Sustainability funding

25 Testimonials Nicole, de Souza Nurse I was diagnosed with cancer. I think that people who are diagnosed with cancer deserve the best care that a nurse can give them. There s one thing that I wish I had when I went through cancer and it was a nurse who had a bit of training that de Souza Institute offers in psychosocial support. Mary, Cancer Survivor You are promoting such a great service here that will be a huge benefit to so many. It is important work you are all doing! Thunder Bay Regional Health Science Centre, 2011 This prestigious National Award (CAN Innovation Award) recognizes our overall commitment to lifelong learning and the commitment to advanced specialty education across the organization and the strength of our collaboration with the de Souza Institute and our Regional Cancer Program. Cori Watson 95% of our oncology clinic nurses are now CNA certified in Oncology and 25% of them also hold national palliative certification due in large part to de Souza support through virtual study groups including an in person exam prep day in Toronto. Dr. Linda Patrick, Dean, University of Windsor To offer advanced preparation in oncology and palliative care- a unique opportunity for professional development at the graduate level. This program will be one-of-a-kind, using the most up-todate technology. CANO The collaboration (between de Souza Institute and CANO) will focus on increasing awareness about oncology nursing to nurses, student nurses and public through educational opportunities and to build excellence in oncology nursing. Carolyn, de Souza Student I call myself a de Souza fantastic because I have taken just about every course or program they offer. It s amazing to feel confident that I m providing the safest and best possible cancer care for my patients Inara, de Souza Student de Souza Institute has taught us to manage (chemotherapy side effects) much, much better.

26 Thank-you