To alleviate the barriers in the management of a pulmonary nodule, a clinic with a nurse navigator model was used. The results from a dedicated lung nodule clinic are reported.
Initial triage by a Nurse Navigator with Clinician Specialist evaluation of a pulmonary nodule at the clinic aimed to decrease delay, and to provide a stratified approach with all disciplines involved in the care of these patients. Eighteen months of data is collected and any noted delays are monitored and addressed.
Out of 324 total patients triaged by the Nurse Navigator, 262 (81%) of those patients were seen in consultation by a Clinician Specialist and Nurse Navigator for evaluation of a pulmonary nodule. Two hundred twenty-seven (87%) patients had a history of smoking. One hundred seventy-seven (68%) were scheduled for standardized follow-up with CT scans at predetermined intervals. One hundred nine (42%) were male, one hundred fifty-three (58%) were female and median age was 63. Twenty-five (10%) were referred to Thoracic Surgery and twenty-seven (10%) were confirmed cancers. A significant decrease (61%) in the delay was demonstrated in surgically resected lung cancer patients with a mean reduction of 38 days compared to our prior retrospective analysis.
The National Cancer Institute published that a Nurse Navigator model in a cancer clinic has shown to expedite care, improve survival, and provide the most needed comfort and satisfaction for patients and family. Our study supports and validates the use of a Nurse Navigator model in a lung nodule clinic to help detect early lung cancers, and to avoid inherent delays in the management of lung cancer. A nurse navigator approach also helped in arranging standardized follow up of indeterminate pulmonary nodules, patient education, smoking cessation, and orderly triage of patients within various departments of the hospital system.
Despite advances in imaging technology, there are significant delays in the diagnosis and management of early lung cancer. Delays in the management were identified and rectified.
Korambeth Ravikrishnan, No Financial Disclosure Information; No Product/Research Disclosure Information