No votes yet
Journal Club
Open Access Article

A Nurse Practitioner-Led Urgent Care Center: Meeting the Needs of the Patient With Cancer

Tracy A. Ruegg
CJON 2013, 17(4), E52-E57 DOI: 10.1188/13.CJON.E52-E57

Providing comprehensive care for patients with cancer is complex with regard to severe treatment-related side effects. Hundreds of thousands of patients with cancer visit the emergency department (ED) each year, and more than half report multiple visits. In the United States, few of the National Cancer Institute-designated cancer centers have an ED specifically for patients with cancer. EDs often are an overcrowded and expensive way in which to care for the urgent needs of patients with cancer. In addition, a looming shortage exists for both primary care providers and oncologists who can address symptom issues. As the Affordable Care Act is implemented, more patients will enter the healthcare system, placing a demand on providers that the current supply cannot meet. A report from the Institute of Medicine advocates that nurse practitioners (NPs) are more than competent to provide for the unique urgent care needs of patients with cancer. The aim of this article is to describe an NP-led urgent care center for patients with cancer and how that care center provides access to vital, expeditious, and cost-effective care.


Ahn, S., Lee, Y. S., Lim, K. S., & Lee, J. L. (2012). Emergency department cancer unit and management of oncologic emergencies: Experience in Asan Medical Center. <i>Supportive Care in Cancer, 20</i>, 2205-2210. doi:10.1007/s00520-012-1478-8

Aisner, J. (2007). Overview of the changing paradigm in cancer treatment: Oral chemotherapy. <i>American Journal of Health-System Pharmacy, 64</i>(Suppl. 5), S4-S7. doi:10.2146/ajh p070035

American Association of Medical Colleges. (2012). Recent studies and reports on physician shortages in the U. S. Retrieved from <a target="_blank" href='http://www.aamc.org/download/100598/data'>http://www.aamc.org/download/1...

American Cancer Society. (2013). <i>Cancer facts and figures 2013.</i> Atlanta, GA: Author.

American Society of Clinical Oncology. (2007). Significant oncologist shortage predicted by 2020. Retrieved from <a target="_blank" href='http://www.asco.org/press-center/significant-oncologist-shortage-predict...

Auerbach, D. I. (2012). Will the NP workforce grow in the future? New forecasts and implications for healthcare delivery. <i>Medical Care, 50</i>, 606-610. doi:10.1097/MLR.0b013e318249d6e7

Barbera, L., Taylor, C., & Dudgeon, D. (2010). Why do patients with cancer visit the emergency department near the end of life? <i>Canadian Medical Association Journal, 182</i>, 563-568. doi:10.1503/cm aj.091187

Bozdemir, N., Eray, O., Eken, C., Senol, Y., Artac, M., & Samur, M. (2009). Demographics, clinical presentations, and outcomes of cancer patients admitted to the emergency department. <i>Turkish Journal of Medical Sciences, 39</i>, 235-240.

Chang, E., Daly, J., Hawkins, A., McGirr, J., Fielding, K., Hemmings, L., … Dennis, M. (1999). An evaluation of the nurse practitioner role in a major rural emergency department. <i>Journal of Advanced Nursing, 30</i>, 260-268. doi:10.1046/j.1365-2648.1999.01071.x

Graham, M. C., & Dellinger, R. W. (2001). Emergency department patients within the scope of nurse practitioner practice. <i>American Journal for Nurse Practitioners, 5</i>, 29-42.

Institute of Medicine. (2011). <i>The future of nursing: Leading change, advancing health.</i> Washington, DC: National Academies Press.

Mayer, D. K., Travers, D., Wyss, A., Leak, A., & Waller, A. (2011). Why do patients with cancer visit emergency departments? Results of a 2008 population study in North Carolina. <i>Journal of Clinical Oncology, 29</i>, 2683-2688. doi:10.1200/JCO.2010.34.2816

Mazur, K. A., McCarthy, K., Suell, M. N., & Hockenberry, M. J. (2012). An outpatient urgent care bay within a pediatric cancer and hematology center. <i>Journal of Pediatric Oncology Nursing, 29</i>, 206-210. doi:10.1177/1043454212445389

McKenzie, H., Hayes, L., White, K., Cox, K., Fethney, J., Boughton, M., & Dunn, J. (2011). Chemotherapy outpatients' unplanned presentations to hospital: A retrospective study. <i>Supportive Care in Cancer, 19</i>, 963-969. doi:10.1007/s00520-010-0913-y

Mehrotra, A., Liu, H., Adams, J. L., Wang, M. C., Lave, J. R., Thygeson, N. M., … McGlynn, E. A. (2009). Comparing costs and quality of care at retail clinics with that of other medical settings for 3 common illnesses. <i>Annals of Internal Medicine, 151</i>, 321-328. doi:10.7326/0003-4819-151-5-200909010-00006

Merritt, B., Naamon, E., & Morris, S. A. (2000). The influence of an urgent care center on the frequency of ED visits in an urban hospital setting. <i>American Journal of Emergency Medicine, 18</i>, 123-125. doi:10.1016/S0735-6757(00)90000-7

Mistry, P. R., & Litaker, D. G. (2000). Surviving the prospective payment system: Potential problems and solutions to ensure quality of care. <i>American Journal of Managed Care, 6</i>, 1305-1311.

Moote, M., Krsek, C., Kleinpell, R., & Todd, B. (2011). Physician assistant and nurse practitioner utilization in academic medical centers. <i>American Journal of Medical Quality, 26</i>, 452-460. doi:10.1177/1062860611402984

Murphy-Ende, K. (2002). Advanced practice nursing: Reflections on the past, issues for the future. <i>Oncology Nursing Forum, 29</i>, 106-112. doi:10.1188/02.ONF.106-112

O'Hara, R., O'Keefe, C., Mason, S., Coster, J. E., & Hutchinson, A. (2012). Quality and safety of care provided by emergency care practitioners. <i>Emergency Medical Journal, 29</i>, 327-332. doi:10.1136/emj.2010.104190

Press Ganey. (2010). <i>Emergency department pulse report: Patient perspectives on American health care.</i> South Bend, IN: Author.

Robles, L., Slogoff, M., Ladwig-Scott, E., Zank, D., Larson, M. K., Aranha, G., & Shoup, M. (2011). The addition of a nurse practitioner to an inpatient surgical team results in improved use of resources. <i>Surgery, 150</i>, 711-717. doi:10.1016/j.surg.2011.08.022

Rubenstein, E. B. (1998). Evaluating cost-effectiveness in outpatient management of medical complications in cancer patients. <i>Current Opinion in Oncology, 10</i>, 297-301. doi:10.1097/00001622-1998 07000-00004

Ryan, K., & Rahman, A. (2012). Examining factors influencing patient satisfaction with nurse practitioners in rural urgent care centers. <i>Journal of the American Academy of Nurse Practitioners, 24</i>, 77-81. doi:10.1111/j.1745-7599.2011.00688.x

Sakr, M., Kendall, R., Angus, J., Sanders, A., Nicholl, J., & Wardrope, J. (2003). Emergency nurse practitioners: A three part study in clinical and cost effectiveness. <i>Emergency Medicine Journal, 20</i>, 158-163. doi:10.1136/emj.20.2.158

Simonet, D. (2009). Cost reduction strategies for emergency services: Insurance role, practice changes, and patients accountability. <i>Health Care Analysis, 17</i>, 1-19. doi:10.1007/s 10728-008-0081-0

Uramoto, H., Iwashige, A., Kagami, S., & Tsukada, J. (2007). Prediction of emergency hospitalization of outpatients receiving cancer chemotherapy. <i>Anticancer Research, 27</i>, 1133-1136.

Urgent Care Association of America. (2011). <i>The case for urgent care.</i> Retrieved from <a target="_blank" href='http://www.ucaoa.org/docs/WhitePaperTheCaseforUrgentCare.pdf'>http://www...

Weinick, R. M., Burns, R. M., & Mehrotra, A. (2010). Many emergency department visits could be managed at urgent care centers and retail clinics. <i>Health Affairs, 29</i>, 1630-1636. doi:10.1377/hlthaff.2009.0748

Zilm, F. (1999). Urgent care and the emergency department: Providing the right ambulatory care settings. <i>Journal of Ambulatory Care Management, 22</i>, 1-7.