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 patient’s safety

16. Good Patient Communication • Empathy • Sincerity • Engagement/Connection with patient • Clarification of Patient’s 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