Sentinel node referent nurse: Description, validation and application in clinical practice

Introduction: In 2019 the opportunity to add a nurse within the radioguided surgery (RGS) team was generated. The referent nurse model was adapted to, the sentinel node (SN) preoperative approaches.

Objectives: To describe the process performed to define the sentinel node referent nurse (SNRN) profile, to validate its practical application and to establish its clinical implementation.

Material and methods: Methodology of analysis and continuous improvement in the management of processes (cycle PDCA): definition and planning of the SNRN functions in the breast cancer protocol, performance of a pilot test with 20 patients and analysis of the data in order to validate the circuit and establish its final clinical implementation.

Results: New procedure flows-charts were elaborated, adding the figure of the SNRN, its function and nursing interventions during the process. In the pilot test a 58.3% reduction in subjective anxiety, a 75% decrease of the overall anxiety level, a 100% knowledge of the test and an acceptable patient perception of pain's level during the radiotracer administration were obtained. Regarding technical quality, 8/10 items assessed reached the level previously established by the RGS team.

Conclusions: The increasing complexity of the SN biopsy technique has created the opportunity to implement nursing care in the presurgical SN localization process. The profile of the SNRN is ideal for carrying it out and has led to improvements in the nursing diagnoses and assessed items.