Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

Implementation of an immuno-oncology cancer nurse coordinator role in a tertiary hospital:  Six month evaluation (#356)

Helen Westman 1 , Margaret Fry 2 3 , Stephen Clarke 1 4 , Nick Pavlakis 1 4 , Rowena Broadbent 1 , Alexander Guminski 1 5 , Alexander M Menzies 1 4 5
  1. Medical Oncology, Royal North Shore Hospital, St Leonards, NSW, Australia
  2. Research and Practice Development, Northern Sydney Local Health District, Sydney, NSW, Australia
  3. University of Technology , Sydney , NSW , Australia
  4. Sydney Medical School, University of Sydney, Sydney, NSW, Australia
  5. Melanoma Institute Australia, Sydney, NSW, Australia


To evaluate the implementation and impact of an Immuno-Oncology (I-O) Cancer Nurse Coordinator (CNC) role for oncology patients receiving immunotherapy.


As part of a 12 month pilot study, a six month evaluation was conducted in one tertiary referral metropolitan hospital. Patients treated with checkpoint immunotherapy were included. Melanoma patients were excluded due to established CNC support.  Data collected included: patient and staff surveys; day unit (DTU) length of stay (LoS); medical officer referrals; CNC consultations; and adverse events. Medical records; the CNC database; DTU records; and incident monitoring databases were reviewed.


Over the six month period 34 patients received immunotherapy. The CNC undertook 374 episodes of patient care, 37% occurring in the DTU with a mean of three interventions per episode.  Interventions included education, assessment, referrals and phone support.  Mean consultation time was 23 minutes.  Mean DTU LoS for patients receiving anti PD-1 therapy reduced by 63 minutes compared to pre CNC implementation.  Emergency department avoidance occurred for four patients and DTU avoidance occurred on 14 occasions due to pre-treatment CNC review.  I-O related adverse events reduced from two to one compared to the preceding six months.  The patient survey response was 60% (n=12; n=4 lost to follow up) of which 66.6% (n=8) reported that first point of care contact was the CNC instead of the ED, GP or oncologist.  Medical registrars (n=4) reported that the CNC role reduced their DTU workload burden by 25-50%.  The DTU nurse survey response was 70.6% (n=12); 83.3% (n=10) of nurses perceived that the role had reduced their workload and 83.3% (n=10) reported that they now consulted the CNC instead of the registrar. 


Initial results suggest that an Immuno-Oncology Cancer Nurse Coordinator role is valuable in reducing the workload burden of medical staff, enhancing patient flow and preventing ED attendance.