• Eur J Oncol Nurs · Dec 2019

    The impact of Clinical Nurse Specialists on the decision making process in cancer multidisciplinary team meetings: A qualitative study.

    • Isla Wallace, Helen Barratt, Sarah Harvey, and Rosalind Raine.
    • Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. Electronic address: i.wallace@ucl.ac.uk.
    • Eur J Oncol Nurs. 2019 Dec 1; 43: 101674.

    PurposeThere are well-documented barriers to nurse participation in cancer multidisciplinary team (MDT) meetings. This paper aims to identify the approaches used by Clinical Nurse Specialists (CNSs) in this setting to contribute during discussion, and to consider the impact of these approaches on the decision making process. In doing so it aims to highlight ways that CNSs can increase their influence, and enhance multidisciplinary engagement.MethodsThis study is based on analysis of observation data from 122 MDT meetings in gynaecology, haematology and skin cancer MDTs. Field notes were reviewed, identifying 58 cases where CNSs contributed to MDT discussion. Audio recordings of the relevant sections were then transcribed and analysed thematically.ResultsFive approaches were used by CNSs to contribute in MDT meetings: sharing information, asking questions, providing practical suggestions, framing and using humour. These approaches influenced three key intermediary processes identified during the analysis ('successful contributions'): prompting discussion, influencing a treatment plan and facilitating teamwork. CNSs contributed successfully in cases where medical factors (such as relapsed disease or complex comorbidities) or non-medical factors (such as strong patient preference), had the potential to impact on the ability of teams to deliver treatment.ConclusionsCNSs have an important role in cancer MDT meetings. By focusing on a subset of cases where CNSs contributed during MDT discussion, this study has provided an insight into approaches that can be adopted by CNSs to increase their influence on the decision making process, enabling teams to capitalise on their knowledge and expertise in MDT meetings.Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.

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