Survivorship and notes The final two sections are blank when patients receive their binders. Patients receive their survivorship care plan at the end of treatment; and the tenth, and final, section has blank paper for notes and calendars.

After the sections were completed, a welcome letter was composed. The letter gives a brief explanation of what to find in the binder and suggests patients bring it with them when they come for treatments or hospital stays. The letter also lists the phone numbers for the office, the hospital, social work, dietary, and case management.

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After using the binder a few times, we identified some changes that could improve it. First, the initial binder had 2-inch rings; however, we found this was too big. A 1½-inch binder works just fine and saves space.

We found other handouts on the CDC Web site that could be helpful for oncology patients. As a result, handouts on flu shots and neutropenia were added to the infection prevention section.

Although we developed a section on clinical trials and genetic testing, we found there were still not a lot of options available. After meeting with the American Cancer Society, the Clinical Trial Matching Service Information was added to the binder. This information helps patients look for clinical trials and complete the paperwork for participation.

Another addition to the book was Five Wishes from the Aging With Dignity organization. This resource covers personal, emotional, spiritual, and medical needs of the person with a chronic illness.

Patient education resources

• American Cancer Society
• Aging with Dignity
• National Cancer Institute


When the binders were developed, the nurses reviewed the material and were given the opportunity to ask questions. It was a great teaching moment for the nurses. The binders have made patient education discussions run a lot smoother, and the nurses feel more confident in their teaching. They know that everything that needs to be taught is in one place. If a nurse is called away during a teaching session or does not cover a topic, the session can easily be continued by another nurse or at a later time. The unit’s nurses are more engaged in teaching, and when the supply of binders is getting low, they immediately call for more.

Patients and families have been very appreciative of the binder. Most inpatients read the material while still in the hospital and ask follow-up questions during their hospital stay. Families are more proactive in asking about transportation and home care needs. When the binder is referenced, the nurses are more comfortable reviewing the information with patients and their families. Some outpatients bring their binder with them at all visits, and those who do not will reference the binder and the material provided in their discussions with the nurses.

The binders have improved our cancer program. Our nurses are more confident when providing patient education. Understanding why certain topics are taught has helped the nurses grow to be better oncology nurses. Patients and their families are empowered by the education. Standardized patient education program gives patients and their families permission and opportunities to ask questions, which has helped patients have more control of their cancer journey.

Heather Askren is an oncology nurse at Franciscan St. Elizabeth Health in Lafayette, Indiana. 


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2. Jenkins V, Fallowfield L, Saul J. Information needs of patients with cancer: results from a large study in UK cancer centres. Br J Cancer. 2001;84(1):48-51.

3. Oncology Nursing Society. Neutophil: Your One-in-a-million Bodyguard Guides You Through Neutropenia. Pittsburgh, PA: Oncology Nursing Society; 2006.

4. Institute of Medicine. Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington, DC: National Academies Press; 2008.

5. Commission on Cancer. Standard 3.2: psychosocial distress screening. In: Commission on Cancer. Cancer Program Standards 2012: Ensuring Patient-Centered Care. Chicago, IL: American College of Surgeons; 2012:76-77.