Specialist nurse key worker in children's cancer care: Professionals' perspectives on the core characteristics of the role.

PURPOSE

To describe the development and implementation of the specialist nurse key worker role across 18 children's cancer centres in the United Kingdom, and draw out significant factors for success to inform future development of the role across a range of specialities.

METHOD

Data were obtained through 42 semi-structured interviews and a focus group with 12 key workers. Framework analysis revealed two main themes: models of care and key workers' perspectives of the role.

RESULTS

Four models of care were identified and described, roles were organised along a continuum of in reach and outreach with either the presence or absence of home visits and direct delivery of clinical care. Key workers' perspectives of the advantages of the role included: coordination of care (being the main point of contact for families/professionals), experience and expertise (communication/information) and the relationship with families. The main challenges identified were: time, caseload size, geographical area covered, staffing numbers and resources available in the hospital and community.

CONCLUSION

The label 'key worker' was disliked by many participants, as the loss of 'specialist nurse' in the title failed to reflect professional group. Leaving aside terminology, key workers shared core role elements within a continuum of in reach and outreach work and their involvement in direct clinical care varied throughout the pathway. Irrespective of the model they worked in, the key worker provided clinical, emotional, educational, and practical support to families, through the coordination of care, experience and expertise and relationship with families and professionals.