EONS Cancer Nursing Index 2020
In the RECaN project EONS highlighted important differences in cancer nursing across Europe. EONS Cancer Nursing Index 2020 was developed by the EONS Advocacy Working Group to illustrate the development and status of this profession in Europe. The index (with scores from 0-100) includes 22 items covering the following dimensions: Education and Career Development, Patient and Occupational Safety, Recognition, Working Conditions and Impact and Workforce.
The Index is based on data from the following sources;
- A range of data bases including the EONS Survey on Patient and Occupational Safety (anonymous survey, available in 7 languages, with over 500 responses from cancer nurses in 38 countries)
- Interviews with leading cancer nursing experts. Nurses from 38 of 42 invited countries participated
- Work force statistics (from ec.europe.eu/Eurostat and OECD)
A scoring system was developed by EONS Advocacy Working Group to reflect the level of development for the different Index dimensions/items. For items with a variety of responses from the same country, the most frequently reported response was used. The purpose of the Index is primarily not to rank some countries as better than others but to illustrate cancer nursing profiles, differences and areas in need of development. The Index could be used in the development of cancer nursing in each country but also for general European progress.
Education and Career Development
This dimension, with 5 items and a maximum score of 23, includes each country’ cancer nursing education levels and academic development, and also the level of established advanced practice roles and recognition of EONS Cancer Nursing Education Framework.
Patient and Occupational Safety
This dimension, with 8 items and a maximum score of 36, covers access to safety guidelines and personal protection equipment (PPE) for handling cytotoxic drugs, systematic testing of occupational exposure, guidelines and exposure for pregnant and/or breast-feeding nurses, whistle blower policies, formal training before administering cytotoxic drugs and finally, frequency of nurses preparing cytotoxic drugs.
Working Conditions and Impact
This dimension, with 4 items and a maximum score of 20, includes level of adherence to the European Working Time Directive (EWTD), risk of negative consequences for nurses denying handling cytotoxic drugs during planned pregnancy/pregnancy/breast feeding, frequency of beds closed, or cancer treatments delayed due to cancer nursing shortage.
This dimension, with 4 items and a maximum score of 18, includes the countries’ level of establishment of nurse-led care, national cancer plan including nursing issues, proportion of cancer centers with a Board position dedicated to cancer nursing and whether a national cancer nursing organisation is established.
This item includes 1 item (maximum score 3) and consists of data on the number of practicing nurses/1000 citizens (ec.europe.eu/Eurostat and OECD).
Among the included countries, the total scores of the EONS Cancer Nursing Index 2020 vary between 16 and 78 (maximum score 100). Ireland obtained the highest total score and we congratulate the Irish cancer nurses for this achievement. Our conclusion is that cancer nursing needs to be strengthened in all 38 countries, to guarantee high quality and safe cancer care. We found a large variation in scores between the five dimensions, illustrating the differences in cancer nursing profile between the countries. While some countries scored higher in education and career development and/or safety, others scored higher on working conditions and impact.
Communication and dissemination
The EONS Cancer Nursing Index 2020 will be used in the continuing work to achieve EONS’ vision that cancer nursing will be recognised by the cancer community and national and European – level policy makers, as a profession with specialized training and qualifications available across the continent. A dissemination plan for the Index is currently being developed by the Advocacy Working Group. It will be possible for EONS members to obtain a national profile for their country and data from the index will be presented at upcoming events and across EONS Social Media platforms. The plan is to update the Index in 2022 for comparisons.