The Memorial Sloan Kettering Cancer Center in New York, New York, began a nurse-led initiative in 2019 called the outreach RN (ORN). The ORN provides support and assistance to oncology nurses by assisting as patient care needs escalate in critically ill patients prior to transfers to more advanced care units. The successes and applications of the ORN were described in a report published in the Clinical Journal of Nursing.

During the 4-month pilot program, the ORN was available 5 days a week, 8 hours per day. Each day 1 to 2 patients were consulted for an average of 70 minutes. Following the positive impact on inpatient care, the ORN was extended to 12 hours per day in 2020, in which 3 patients were consulted for an average of 83 minutes per day.

Nursing staff (n=88) and providers (n=11) was asked to assess the utility of the ORN. Most (89%) felt the ORN knowledgeable, successfully facilitated safe transfers (80%), and improved communication during patient events (72%). In the free response section of the questionnaire, participants supported the program, stating that the ORN empowered staff and improved patient satisfaction.


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The qualifications of the ORN included advanced cardiopulmonary life support certification, critical care nursing certification, experience as a critical care nurse for 3 years or longer, expert in dysrhythmia interpretation, and strong communication and interpersonal skills.

To incorporate the ORN program successfully, clear delineation of responsibilities between all nursing staff was critical. A system for allowing the ORN to rapidly respond to critical situations in a timely manner was needed. Staff education and training on how to incorporate the ORN into patient care was key.

Reference

Lucas V. Outreach RN: a nurse-led initiative to improve transitions in care for critically ill patients with cancer. Clin J Oncol Nurs. 2020;24(6):605-608. doi:10.1188/20.CJON.605-608