Staffing in the infusion center is a top priority for cancer centers, but there is no gold standard for nurse-to-patient ratios in oncology. This is especially true in infusion centers where patient complications and acuity make nursing effort and time difficult to forecast. To help, we collected data from over 250 infusion centers—here's what we learned about chemotherapy nurse staffing.
Higher patient volumes translate into more chemotherapy RNs
It is not surprising that facilities with the highest patient volumes also employ the most chemotherapy RNs. For example, academic medical centers reported the highest daily infusion center patient volumes while employing the largest number of chemotherapy RNs. Meanwhile, freestanding cancer centers had the lowest patient volumes and the smallest number of RNs.
Chemotherapy RNs at AMCs responsible for fewer chairs/beds
Furthermore, at academic medical centers, chemotherapy RNs are responsible for fewer infusion chairs and beds—a median of 2.1 chairs and/or beds and 4.4 patients per day. Their counterparts in the freestanding setting are responsible for a median of 3.6 beds and/or chairs and 5.0 patients per day. These data reflect the likelihood that chemotherapy RNs at AMCs are likely treating a higher number of more complex and acute patients. It’s also worth mentioning that there are significant limitations to this calculation. This analysis is meant to provide a benchmark for the ratio of chairs to chemo RNs, but it does not reflect the number of chairs or beds that one chemo RN may be responsible for at any given time.
Few facilities require nurses to have ONS certification
Given the mixed evidence on the impact of ONS certification on clinical outcomes, it is understandable that few facilities require their nurses to be certified. Only one-third of respondents require ONS certification, and even fewer pay certified nurses more. However, there is some evidence that certification improves nurses’ adherence to evidence-based pain and symptom management, which may be one possible method of improving the patient experience.