McDermott K C
Memorial Sloan-Kettering Cancer Center, New York, NY.
Oncol Nurs Forum. 1994 Jun;21(5):827-32.
To review changes in the healthcare delivery system and project the challenges that practitioners and consumers will face in a reformed environment.
Professional journals and books, print media, and government releases.
Analysis of projected reform plans, discussions of issues related to complex social, economic, and political factors, and considerations for practice changes for oncology nurses.
The pending dominance of healthcare delivery through managed-care systems will challenge oncology care providers and consumers.
Oncology nurses must identify the opportunities, master the challenges, and adapt to the trends of the reformed healthcare system. The delivery of long-term care to senior citizens, patients with AIDS, and individuals from diverse cultures will shift to more community, ambulatory, and rural managed-care settings. Oncology nursing practice in these environments raises questions about prevention and screening, diagnosis, treatment, follow-up, alternative care, and research. Oncology nurses, especially advanced practice nurses, will play a pivotal role in reshaping the delivery of patient care and in designing the future of their profession.
回顾医疗保健服务体系的变化，并预测从业者和消费者在改革后的环境中将面临的挑战。
专业期刊和书籍、印刷媒体以及政府发布的信息。
对预计的改革计划进行分析，讨论与复杂的社会、经济和政治因素相关的问题，并考虑肿瘤护理人员实践变化的因素。
通过管理式医疗系统提供医疗保健服务的主导地位即将确立，这将给肿瘤护理服务提供者和消费者带来挑战。
肿瘤护理人员必须识别机会、应对挑战，并适应改革后的医疗保健系统的趋势。为老年人、艾滋病患者和来自不同文化背景的个人提供长期护理的服务将转向更多的社区、门诊和农村管理式医疗环境。在这些环境中提供肿瘤护理服务会引发关于预防与筛查、诊断、治疗、随访、替代护理和研究等方面的问题。肿瘤护理人员，尤其是高级实践护士，将在重塑患者护理服务以及规划其职业未来方面发挥关键作用。
