Oncology Rounds

Do you have the right chemo nurse staffing ratios?

by Jacob Dingle and Emily Heuser

Optimal staffing ratios are critical to the success of any cancer program, but variable patient complexity and task acuity makes it difficult to land on a staffing model that works well across the board. Correctly calibrated nurse staffing levels are particularly important to maintain efficiency in infusion centers. By far, the most common question we receive from cancer programs is, "How many chemo nurses should I have?"

Get more infusion center benchmarks with our generator

This is a tough question to answer. While benchmarks are never perfect, they can be a valuable starting point to understanding your performance and opportunities to improve. That's why we recently updated our infusion center benchmarks, including data from 125 infusion centers. Our analysis focuses on hospital-based programs due to limited responses from freestanding centers and independent physician practices.

Facilities with larger volumes generally reported higher numbers of chemo RNs

Academic medical centers (AMCs), with higher volumes of daily patients, reported lower numbers of daily patients per chemotherapy RN, and the average RN in those facilities has approximately 3.7 daily patients. This increases to 4 daily patients per RN in non-teaching hospitals, which report lower volumes on average.

Though the difference in average number of daily patients per chemo nurse is small between facility types, it suggests that nurses at AMCs may treat a greater number of complex patients and thus have slightly lower daily patient loads.

Chemotherapy RNs at AMCs also responsible for fewer chairs/beds

The number of chairs and beds per chemotherapy nurse is more variable between facilities than the number of daily patients. AMCs report a median of 1.7 beds and/or chairs per chemo RN, compared with 2.4 at teaching hospitals and non-teaching community hospitals. 

AMCs dedicate more RNs to clinical trials; percentage of dedicated RNs similar regardless of facility

Unsurprisingly, AMCs have a larger number of RNs dedicated to clinical trials. What may be a bit more unexpected is that, regardless of facility type, the percentage of chemotherapy RNs dedicated to clinical trials deviates little from the national average of 14.3%. For example, AMCs employ an average of 17 chemo RNs. Of those, 2.4—or 14.3%—are dedicated to working with patients on clinical trials.

More institutions requiring ONS certification for chemo RNs

Since 2015, the number of facilities requiring Oncology Nursing Society (ONS) certification for their chemotherapy RNs increased, reaching just under 50% of facilities on average. While numbers regarding the exact impact of ONS certification are difficult to obtain, this increase may be in part due to some evidence that attributes better patient outcomes to a higher percentage of certified nurses, as well as accreditations like the CoC making it a part of their requirements.

Charting the cancer patient journey—from diagnosis to survivorship

In this infographic, we've complied our top findings from the 2019 Cancer Patient Experience survey, so you can better understand patient priorities and preferences for care.

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