Nurse Navigator: development of a program for Brazil.
Fernanda Felipe Pautasso, Thafarel Camargo Lobo, Cecília Dias Flores and 1 others
PMID 32491120WHAT IT FOUND
A nurse-led cancer navigation program and a patient need-for-navigation scale were developed and validated by expert consensus in a Brazilian oncology centre.
The scale sorts patients into navigation levels, but the paper did not test whether navigation improved patient outcomes.
Key findings
01The program was designed for head and neck cancer patients after service data showed head and neck surgery was among the specialties with the highest consultation volume.
02The Need for Navigation Assessment Scale was validated by expert consensus, with a final consensus index of 96.42% after two Delphi rounds.
03The study did not test whether the navigation program improved patient care; the authors say effectiveness evaluation was not possible within the study time.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not measure patient outcomes, so it cannot show that navigation improves cancer care. The Delphi panel was intentionally selected and small: 21 experts were invited, 17 took part in round 1 and 12 in round 2. The program was developed in one philanthropic high-complexity oncology centre in southern Brazil, so its fit for other services or countries is not known. The scale was judged by expert consensus, not tested in patients for whether it correctly identifies need or improves navigation. The published scale text includes an inconsistent score range, with 13 to 12 points listed for navigation level 2, so the scoring rules need verification.
The easy way to misread this
Do not read the validated scale and program model as evidence that nurse navigation improves cancer care. The authors state that effectiveness evaluation was not possible, and the paper reports no patient outcomes.