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M. D. Anderson nurses find empowerment in PACTs

PHILADELPHIA - According to nurse-researchers at The University of Texas M. D. Anderson Cancer Center in Houston, participation among nurses in the institution's unique Professional Action Coordinating Teams (PACTs) has increased 50 percent in one year.

In a poster presented at the 33rd Annual Congress of the Oncology Nursing Society, Debbie Cline, RN, BSN, OCN and Patricia Johnston, MS, BSN, RN, OCN, reported that the PACTs attracted more than 353 new participants from the nursing community at M. D. Anderson from March 2007 to March 2008. When the data were gathered, there were 2,689 nurses working at M. D. Anderson.

Unique to M. D. Anderson, PACTs are ad hoc, multidisciplinary committees charged with resolving nursing practice issues within a set timeline determined by each work group. The issues assigned to PACTs are determined by M. D. Anderson's Nursing Practice Congress, a 36-member delegation elected by its peers.

Cline attributes the growth to the PACTs to a short and definable commitment of time (usually three to 24 months), a track record for decisive action, a strong influence on nursing practice at M. D. Anderson and an opportunity to hone leadership skills.

"It's quite impressive to see such a large increase in participation among many nursing disciplines at M. D. Anderson," said Cline, who is a clinical nurse on M. D. Anderson's stem cell transplant in-patient floor and chair of the institution's Nursing Practice Congress. "We believe that participation in the PACTs is increasing not only because they affect our practice but because they are supported by leadership and enable nurses to make better decisions at the patient's bedside. PACTs are comprised of multidisciplinary members including nurses, and address clinical nursing issues, but ultimately, it is the patient who benefits."

The greatest increase in participation was among clinical nurses, a group whose representation on the PACTs increased 185 percent at M. D. Anderson from March 2007 to March 2008. Clinical nurses comprise 62 percent of the total nursing population at M. D. Anderson and in 2007, approximately 8.8 percent of clinical nurses participated in the PACTs. In 2008, approximately 21.5 percent took part.

According to Cline, other groups that have particularly high representation on the PACTs include nursing management, education/nursing instructors and specialized nurses, such as case managers and those in quality improvement, infection control and nursing informatics.

Since 2006, M. D. Anderson's Nursing Practice Congress has been presented with more than 90 nursing practice issues and established 54 PACTs. To date, the groups have resolved 47 issues, and seven are awaiting review on policies or procedures. Since September 2007, 14 additional PACTs have formed, seven standing committees continue work and 16 issues have been resolved or closed.

Since they were established, PACTs have tackled nursing issues that include developing a nursing-driven venous thromboembolism (VTE) assessment, a better pain assessment tool and a program to reduce the risk of calls among outpatients; clarifying instruction on the care of chest tubes; and enhancing consistency of practice regarding drain care. Other PACTs are devoted to issues such as diversity, Nurses Week activities, electronic medical record planning and competency development.


Contact: Julie A. Penne
University of Texas M. D. Anderson Cancer Center

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