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Table 3 Breast cancer: clinical tasks undertaken by percentage of physicians and nurses, by countries’ SoP, 2015/2016

From: Task shifting between physicians and nurses in acute care hospitals: cross-sectional study in nine countries

 

% Physicians performing tasks

% Nurses performing tasks (all nurses and APN/SN)

 

Countries with SoP expansion [1]

Countries with no/limited SoP expansion [2]

Countries with SoP expansion [1]

Countries with no/limited SoP expansion [2]

Countries with SoP expansion [1]

Countries with no/limited SoP expansion [2]

Breast cancer

% Physicians, N = 91

% Physicians, N = 132

% All nurses, N = 79

% All nurses, N = 242

% APN/SN, N = 46

% APN/SN N = 43

Tasks related to diagnosis/physical examination

 Assessing extent of disease/staging: physical examination[i,ii]

53.8

54.5

16.4***

1.6***

21.7**

0.0**

 Detecting and treating local recurrence: perform physical examination[i,ii]

59.3

63.6

26.5***

2.8***

32.6***

0.0***

 Detecting and treating metastatic diseases: perform physical examination[i,ii]

51.6

61.3

15.1***

3.3***

17.3**

0.0**

 Endocrine/hormonal therapy: perform physical examination[i]

40.6

36.3

13.9***

1.6***

15.2

4.6

 Biological therapy: perform physical examination[i]

10.9***

31.0***

8.8*

3.3*

8.7

9.3

 Interpret ultrasound scan[i]

23.0***

46.2***

3.8

0.8

6.5

0.0

 Clinical interpretation of mammogram[i]

42.8

31.0

5.0*

0.8*

8.7

0.0

 Clinical interpretation of MRI[i]

34.0*

21.9*

2.5

0.8

4.3

0.0

 Clinical interpretation of biopsy[i]

41.7

30.3

3.8*

0.0*

4.3

0.0

 Interpret X-ray[i]

27.4

21.9

2.5

0.0

4.3

0.0

 Interpret CT scan[i]

29.6

21.2

1.2

0.0

2.1

0.0

 Interpret bone scan[i]

21.9

17.4

1.2

0.0

2.1

0.0

Tasks related to treatment/therapy

 Surgical treatment: perform surgical procedures[i,ii]

40.6

43.1

2.5

3.3

2.1

2.3

 Local recurrence: initiate diagnosing treatment[i,ii]

52.7

57.4

21.0***

0.8***

30.4***

0.0***

 Metastatic diseases: initiate diagnosing treatment[i,ii]

47.2

58.3

15.1***

1.2***

19.5**

0.0**

 Chemotherapy: decide on therapy based on lab results and protocols[i]

16.4***

44.7***

24.0***

1.6***

30.4***

0.0***

 Chemotherapy: revise therapy[i]

12.0***

38.6***

22.7**

8.2**

30.4***

2.3***

 Endocrine/hormonal therapy: prescribe therapy[i]

45.0

37.8

12.6**

4.1**

19.5**

0.0**

 Endocrine/hormonal therapy: revise therapy[i]

43.9

34.8

13.9***

1.2***

19.5**

0.0**

 Biological therapy: prescribe therapy[i]

12.0**

31.0**

8.8

5.7

13.0

4.6

 Biological therapy: revise therapy[i]

12.0**

27.2**

11.3**

1.6**

15.2*

0.0*

 Lymphedema: initiate treatment[i]

23.0

33.3

24.0*

12.4*

30.4

20.9

 Cancer-related fatigue: prescribe therapy[i]

7.6***

31.0***

30.3***

7.8***

41.3**

9.3**

Tasks related to prescribing medications

 Prescribe medication related to treatment[i]

37.3

46.9

10.1**

2.0**

13.0*

0.0*

 Adapt medication treatment in the course of therapy[i]

30.7

42.4

16.4**

4.9**

21.7**

0.0**

 Side effects: prescribe medications[i]

27.4**

49.2**

10.1**

2.0**

15.2

2.3

 Administer medications[i]

5.4***

26.5***

17.7**

35.5**

17.3

32.5

 Palliative care: prescribe medications[i]

17.5**

37.8**

6.3

4.1

10.8

0.0

 Palliative care: administer medications[i]

0.0***

13.6***

21.5***

50.4***

21.7

37.3

Tasks related to providing information to patients

 Providing information to patient about test results[ii]

61.5

50.0

35.2***

2.0***

44.6***

6.0***

 Detecting and treating local recurrence: inform patients about results[ii]

53.8

54.2

23.5***

3.1***

34.0***

4.0***

 Detecting and treating metastatic diseases: inform patient about results[ii]

50.5

52.1

16.4***

0.6***

21.2***

0.0***

 Providing information to patient about clinical aspects and perspective of treatment[ii]

58.2

46.4

38.8***

4.8***

48.9***

10.0***

 Surgical treatment: inform patient about surgical treatment[ii]

46.1

52.8

30.5***

11.3***

36.1*

14.0*

 Endocrine/hormonal therapy: inform patient about therapy[ii]

50.5

42.8

32.9***

7.9***

42.5**

18.0**

 Information to patient about non-clinical consequences of treatment[ii]

42.8

40.7

40.0***

5.5***

53.1***

14.0***

  1. Source: MUNROS 2015/2016. Rationale for inclusion of tasks: [i] = suggested clinical activities as Advanced Nursing Practice: diagnosis/advanced health assessment, treatment/therapy, prescribing medications, by International Council of Nurses (ICN), [ii] = common medical tasks, reported by the majority of physicians as being part of normal duties (≥ 50% of physicians in ≥ 50% of countries). [1] England, Scotland, Netherlands, [2] Czech Republic, Germany, Italy, Norway, Poland, Turkey
  2. SoP Scope-of-Practice, APN Advanced Practice Nurses, SN Specialist Nurses
  3. ***p value < .001; ** = p value < .01, * = p value < .05
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