Breast Cancer Nurse Navigation

1
Breast Cancer Nurse Navigation

• Rosemary Clement MSN, APRN-BC, Certified Breast
  Care Navigator

2
Breast Care and the Role of the Navigator

• Breast Cancer has become a special field of
  cancer care
• Unlike other diseases, there is usually many
  kinds of doctors and treatments involved
• The model of patient navigation has been shown to
  be successful in helping patients
• navigate through the cancer trajectory and to
  help save lives

3
History of Patient Navigation

• In 1989, Dr. Harold P. Freeman, as president of
  the ACS, held nationwide hearings that determined
  that poor patients face enormous barriers when
  attempting to obtain cancer care
• In 1990, he established the U.S.s first patient
  navigation program at Harlem Hospital in New York

4
Harlem Hospital Studies

• Data was collected on the outcomes of the program
  and compared five year survival rates
• 1964-1986 vs 1995-2000
• 39 70
• We believe that this survival improvement was
  primarily a result of patient navigation. H. P.
  Freeman, MD

5
Patient Navigation Act

• On June 29, 2005, President George W. Bush signed
  into law the
• Patient Navigator, Outreach, and Chronic
  Disease Prevention Act
• -provides funding to create patient
• navigation services

6
The Patient Navigator

• One person who guides the patient through the
  health care system and follows the patient from
  diagnosis through treatment
• Addresses and anticipates obstacles to care

7
Goals of Patient Navigation

• To Save Lives from Cancer
• -timely diagnosis and treatment
• -educate populations on cancer
• prevention and early detection

8
Goals of Patient Navigation

• To Eliminate Barriers to Care
• -make sure patients are aware of and
• can access available services
• -make sure patients are not lost in
• the follow up

9
Navigator Role and Responsibility

• Outreach
• -expand availability of screening services
• -community education of early detection
• and cancer prevention
• Patient Navigation
• -provide navigation from suspicious
• finding to resolution

10
Navigator Role and Responsibility

• Rehabilitation
• -provide education/support for issues
• related to surviving cancer
• -lymphedema specialist
• -support groups
• -financial help

11
Navigator Resoures

• Financial support services
• Language and translation services
• Rehabilitative services
• Palliative care services
• Community outreach educational services
• Family and support services
• Local advocacy and support services

12
Navigator Tasks

• Bridging cultural and linguistic barriers
• Finding financial resources
• Tracking appointments
• Coordinating transportation
• Referring patients, families and caregivers to
  appropriate services

13
Initial Needs of the Breast Cancer Patient

• Timely Diagnosis
• Disease Education
• Financial Needs Assessment
• Family and Social Assessment
• Family Genetic Assessment
• Nutritional Assessment

14
Needs of the Breast Cancer Patient

• Prosthesis and mastectomy bras
• JP holder or camisole
• Wigs, scarves, hats
• Eyeglasses
• Walkers
• Wheelchairs
• childcare

15
Nurse Navigator Qualities

• Confidentiality
• Respectfulness
• Compassionate
• Mindful of the patients safety

16
Good Patient Communication

• Empathy
• Sincerity
• Engagement/Connection with patient
• Clarification of Patients concerns, and
  knowledge of disease
• Enlistment of partnership in care

17
Benefit to Organizations

• Better sharing of resources
• Improved patient care
• Cost savings
• Enhanced quality of services
• Increased patient satisfaction
• Greater community partnership