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UTHSC Nursing Professor Presents Internationally on Nursing Standards in Global Childhood Cancer Care

Dr. Sarah Day (Photo by Allen Gillespie/UTHSC)

When childhood cancer experts from around the world meet in Lyon, France, this week at the 51st Congress of the Society of Pediatric Oncology (SIOP), they will take on the big issues in addressing treatment of this disease in children.

Keynote addresses will run the gamut from World Health Organization cancer policies to the genomics of renal tumors. However, a faculty member from the University of Tennessee Health Science Center’s College of Nursing will be the only nurse among the experts presenting keynote addresses at the congress Oct. 23-26.

Sara Day, PhD, RN, FAAN, will highlight the importance of nursing care in improving childhood cancer rates worldwide in her keynote address, “International Baseline Standards for Pediatric Oncology: An Interdisciplinary Approach to Achieving Equity in Care Delivery.” Dr. Day is an associate professor and assistant dean for the Center for Community and Global Partnerships in the UTHSC College of Nursing.

SIOP is the only global multidisciplinary society devoted to pediatric and adolescent cancer. It has more than 1,800 members worldwide including doctors, nurses, scientists, researchers, and other health care professionals.

Dr. Day is a member of the SIOP Nursing Working Group for Pediatric Oncology in Developing Countries, whose work was instrumental in the development of the baseline standards for pediatric oncology nursing care in low- and middle-income countries. She has a wealth of experience in the treatment of childhood cancer globally, having served as nursing director for the international outreach program at St. Jude Children’s Research Hospital from 2006 to 2012, and as director of nursing education at St. Jude from 2013 to 2016.

Among the 430,000 children who have cancer worldwide, 87 percent live in low- or middle-income countries. In high-income countries, the childhood cancer survival rate has increased from 20 percent to 83 percent in the last 60 years. However, in low- and middle-income countries, the survival rate has remained low – 23 to 30 percent.

The World Health Organization Global Initiative on Childhood Cancer has set the goal of reaching 60 percent survival of childhood cancer worldwide by 2030. The current worldwide childhood cancer survival rate is 37 percent, with survival rates ranging from 8 percent in Africa to 83 percent in North America.

Any strategy to improve survival rates in low- and middle-income countries must include baseline standards for pediatric oncology nursing care because nurses provide the majority of care for childhood cancer patients in these countries, Dr. Day said.

The baseline standards require resources that are not typically available in low- and middle-income countries. The six recommended standards include:

  • A staffing plan based on patient acuity levels, to include a nurse-to-patient ratio of 1:5 for general pediatric oncology units and 1:2 for critical care and transplant units
  • Formalized pediatric oncology orientation for all new nursing employees, to include two weeks of theory and clinical skills training followed by three to four weeks with an experienced nurse preceptor
  • Continuing education and training to increase pediatric oncology clinical skills and knowledge
  • Recognizing nurses as core members of the multidisciplinary team
  • Access to resources required for safe pediatric oncology care, such as IV pumps and hand-washing supplies
  • Evidence-based pediatric oncology nursing policies and procedures in place to guide the delivery of nursing care

“The critical first step to improving survival of children with cancer in low- and middle-income countries is early diagnosis, an appropriate treatment plan and available drugs,” Dr. Day said. “I will be presenting about the second step, because if the first step is perfectly executed without the second step, survival will not improve. The second step is implementation of the treatment plan and support or the patient and family.”

The keynote address is a recognition of the significance of Dr. Day’s work, said Wendy Likes, PhD, DNSc, APRN-Bc, FAANP, dean of the UTHSC College of Nursing.

“We are extremely proud of Sara and her lifelong dedication to improving the health of individuals and communities regionally and globally,” Dr. Likes said. “Her work is quite extraordinary and has a meaningful impact in saving lives.”