UnderstAnding the evAlUAtion chAllenge

Canadian OnCOlOgy nursing JOurnal • VOlume 25, issue 1, Winter 2015 reVue Canadienne de sOins infirmiers en OnCOlOgie AbstrAct Because nursing interventions are typically complex and dynamic, evaluating their impact upon care and care systems is a notoriously daunting challenge. Nursing organizations seeking to evaluate the impact of their efforts are frequently frustrated by the gap between the evaluation research ideal and their available resources. In this paper, we describe a practical and manageable process developed to address such an evaluation challenge. Using a three-step inquiry approach, supported by modest organizational funding and a realistic level of voluntary member time, we were able to generate a meaningful understanding of intersecting outcomes arising from the implementation of CANO/ACIO’s National Strategy for Chemotherapy Administration. On the basis of our experience, we see considerable merit in both process and outcomes of this form of targeted evaluation. Finding feasible and appropriate ways to evaluate whether or not it has made a difference is among the most complex challenges associated with any nursing innovation. In a dynamic and changing health care world, being able to document impact determines whether an innovation will succeed or fail. Because of this, nurses face significant pressure to find meaningful ways to address the evaluation imperative, not only in finding the time and resources required to conduct an evaluation, but also in identifying a feasible methodology. In this paper, we describe an evaluation methodology we developed for the CANO/ACIO National Strategy for Chemotherapy Administration. This strategic initiative was designed to enhance the level of nursing practice across the system, and we wanted to find a way to understand its impact. In describing this example, we hope to shed light on the nature of these evaluative complexities, document our efforts to enact a manageable and informative evaluation process within limited means, and offer encouragement to other nursing groups faced with similar questions about the enormity of the evaluation challenge.