Title : Seamless transitions, empowered patients: The vital role of oncology nurse navigators from inpatient to outpatient cancer care
Abstract:
Background: Absence of oncology nurse navigators (ONNs) in inpatient oncology led to coordination lapses and diminished patient experience. ONNs improve satisfaction, survivorship planning, and reduce readmissions, their role in bridging inpatient-to-outpatient transitions is less studied. This project explores ONNs integration to address continuity, quality, and outcomes in cancer care.
Objective: The objective of this planning abstract is to develop an evidence-based ONNs program to bridge care coordination gaps and support seamless inpatient-to-outpatient transitions. The project also provides recommendations and evidence-based strategies to improve institutional cancer care processes, addressing the question of how ONNs can enhance transitional care.
Methods: A structured evidence review was conducted using PubMed, CINAHL, ONS, and PMC’s clinical resources. Eligible studies, published within the past five years, examined ONNs interventions related to patient satisfaction, readmissions, and care continuity. Studies included sample sizes ranging from 150 to 825 patients in hospital settings. Data were extracted on outcomes assessed through validated survey instruments, readmission tracking, and care delivery consistency. Completion and response rates were included when available, with most reporting high survey participation. An implementation science framework guided analysis of ONNs integration in inpatient-to-outpatient transitions.
Results: Across studies with 150–825 participants, survey response rates were high (82–95%), with few discontinuations reported, mostly due to clinical factors. ONNs consistently improved satisfaction, empowerment, and comprehension of post-treatment care. Madu & Ajibade (2025) reported reduced readmissions by 10–15% (P < 0.05). Yoo et al. (2024) demonstrated greater survivorship plan use and improved continuity. Marsall et al. (2024) found better health status (B = 0.74, p < 0.001) and fewer medication complications (B = -0.35, p < 0.01), though no significant impact on readmissions (p = 0.39).
Conclusion: ONNs are essential to improve outcomes, empowerment, satisfaction, and continuity during inpatient-to outpatient transitions. Pilot implementation should include staff hiring, education, and ongoing evaluation through satisfaction surveys and readmission monitoring. This project addresses gaps in transitional care and suggests future research on scalability, long-term outcomes, and cost-effectiveness.
