- Email: [email protected]
115 Surgical lung cancer specialist nurse in accordance with NICE standard
S40
Poster abstracts, 11th Annual British Thoracic Oncology Group Conference, 2013: Nursing & Supportive Care
a reduction in overall pain with an improvement in activities previously limited by the post thoracotomy pain. 115 Surgical lung cancer specialist nurse in accordance with NICE standard J. Trinder *. Freeman Hospital, UK Introduction: The role of the surgical lung cancer nurse specialist (SLCNS) is relatively new, encompassing promotion of health and wellbeing of the patients, integrating the knowledge of cancer care and surgical treatments. The role in accordance with NICE guidelines which states that all lung cancer patients should have a key worker throughout each stage of their cancer pathway should become the interface between patient and other members of the multidisciplinary team as the key accessible professional, personalising the patient’s pathway. Aims: Our aim in Newcastle is to ensure that every patient undergoing surgical intervention for lung cancer or palliative surgical treatment has access to the key worker. SLCNS details given to each patient. Ensure patients given right amount of timely information. Offer individual support alleviating anxieties and concerns. Enhance home recovery Support patients with indwelling pleural catheters (IPC). Follow up calls anxieties/deterioration/pain management, complications addressed avoiding unnecessary re admissions. Ensure continuity of care/communication with local lung CNS, District nurse, GP, OT, Macmillan, palliative care and MDT. Achievements: Network links developed, improving coordination and stream lining patients pathway, meeting NICE standard. Mediation between patients and other hospital services quickly addressed. Feedback from the DGH’s has been positive. Independent patient satisfaction survey 49/96 (51%) response rate. Developments: • Increase awareness of service. • Develop surgical support group in conjunction with local District general Hospital. • Develop Nurse led drop in clinic for issues relating to Indwelling pleural catheters and patients pre and post surgery with issues that need to be addressed. • Develop patient satisfaction survey. 116 Improving the surgical patient pathway: A multidisciplinary approach J. Draffan *, T. Fitzpatrick, D. Alton. University Hospital of North Tees & Hartlepool NHS Foundation Trust, UK Introduction: A multidisciplinary approach has been established to support patients undergoing curative surgery and to optimise their physical and psychological status in line with national guidance on the management of lung cancer, rehabilitation and survivorship initiatives (DH 2010, DH 2011, NCAT 2009, NICE 2011). The Lung Cancer Nurse Specialists (LCNS) and Physiotherapist endeavour to assess all patients pre-operatively following a confirmed or clinical diagnosis of lung cancer and continue this support post-operatively following discharge from the regional Cardiothoracic Centre. Anecdotal evidence suggested that not all patients received the same level of support. Method: A retrospective review of the notes was undertaken of all 24 lung cancer patients who had potentially curative surgery between 1.09.11 and 31.08.12. Conclusion: Results demonstrate that the main reason for not having input from both LCNS and Physiotherapy services is due to ineffective communication between local health care teams and tertiary surgical teams. The results of this audit will form the basis for improving the surgical patient pathway with a view to then examining patient satisfaction through a survey.
Way Forward: Present results of the audit to the local lung cancer team and to the Cardiothoracic team. Develop and agree a clear pathway for surgical patients. Design a fax form to inform the Thoracic CNS of pending patients. Ensure effective timely communication within local team and between healthcare teams. To repeat the audit in a year to evaluate progress. Reference(s) Department of Health (2011) Improving Outcomes: A Strategy for Cancer. London: Department of Health. NICE Guidance (2011): Diagnosis and treatment of Lung Cancer. London: Department of Health. NCAT (2009): Lung Rehabilitation Pathway. National Cancer Action Team. Kings College. London. Department of Health (2010) National Cancer Survivorship Initiative. London: Department of Health. 117 National Lung Cancer Forum For Nurses Supported By Lilly Project 2011/2012 Developing guidance for the supportive and palliative care of lung cancer and mesothelioma patients and their carers A. Richardson1 *, J. Draffan2 , J. White3 . 1 University Hospitals of Leicester NHS Trust, UK, 2 University Hospitals of North Tees, UK, 3 Leeds Teaching Hospitals NHS Trust, UK Lung cancer remains the United Kingdom’s commonest cause of cancer death and accounts for 1 in 14 of UK deaths from all cancers. Approximately 41,428 new cases of lung cancer and 2500 new cases of Mesothelioma are diagnosed in the UK (CRUK: Cancer Research UK, 2009.) Eighty per cent of people will present with advanced disease (NLCA: National Lung Cancer Audit 2010) and the majority of these will die within a year of diagnosis (CRUK 2009). This guidance has been developed over an eighteen month period by a dedicated working party with expertise in caring for lung cancer and mesothelioma patients and carers and incorporating current evidence and guidance The document provides detailed supportive and palliative care specialist interventions to help any health care professional who is caring for a patient with advanced lung cancer or mesothelioma. The guidance is focused around nine key elements that were identified in work carried out by the Health Experience Research Group at the University of Oxford. Cancer patients identified areas of their care that were important to them or that they found to be lacking. Holistic approach to care Getting the bad news Care co ordination Responsiveness and ease of access to benefits and support Inpatient care Pain control and symptom management Staff attitudes and empathy End of life choice and the actual experience Carer focus The guidance discusses each element in relation to lung cancer and mesothelioma patients and carers, makes recommendations for good practice and then gives examples of good practice that have been identified. The aim of the guidance is to provide a usable document with evidence and practice examples to assist health care professionals to improve supportive and palliative care within their area. Reference(s) Cancer Research UK (2009): Incidences of Lung Cancer (online.) Cancer Research UK. Available from: http:/ / www.cancerresearch .org/cancerstats/types/lungincidence (accessed 9th September 2011).
Poster abstracts, 11th Annual British Thoracic Oncology Group Conference, 2013: Nursing & Supportive Care
a reduction in overall pain with an improvement in activities previously limited by the post thoracotomy pain. 115 Surgical lung cancer specialist nurse in accordance with NICE standard J. Trinder *. Freeman Hospital, UK Introduction: The role of the surgical lung cancer nurse specialist (SLCNS) is relatively new, encompassing promotion of health and wellbeing of the patients, integrating the knowledge of cancer care and surgical treatments. The role in accordance with NICE guidelines which states that all lung cancer patients should have a key worker throughout each stage of their cancer pathway should become the interface between patient and other members of the multidisciplinary team as the key accessible professional, personalising the patient’s pathway. Aims: Our aim in Newcastle is to ensure that every patient undergoing surgical intervention for lung cancer or palliative surgical treatment has access to the key worker. SLCNS details given to each patient. Ensure patients given right amount of timely information. Offer individual support alleviating anxieties and concerns. Enhance home recovery Support patients with indwelling pleural catheters (IPC). Follow up calls anxieties/deterioration/pain management, complications addressed avoiding unnecessary re admissions. Ensure continuity of care/communication with local lung CNS, District nurse, GP, OT, Macmillan, palliative care and MDT. Achievements: Network links developed, improving coordination and stream lining patients pathway, meeting NICE standard. Mediation between patients and other hospital services quickly addressed. Feedback from the DGH’s has been positive. Independent patient satisfaction survey 49/96 (51%) response rate. Developments: • Increase awareness of service. • Develop surgical support group in conjunction with local District general Hospital. • Develop Nurse led drop in clinic for issues relating to Indwelling pleural catheters and patients pre and post surgery with issues that need to be addressed. • Develop patient satisfaction survey. 116 Improving the surgical patient pathway: A multidisciplinary approach J. Draffan *, T. Fitzpatrick, D. Alton. University Hospital of North Tees & Hartlepool NHS Foundation Trust, UK Introduction: A multidisciplinary approach has been established to support patients undergoing curative surgery and to optimise their physical and psychological status in line with national guidance on the management of lung cancer, rehabilitation and survivorship initiatives (DH 2010, DH 2011, NCAT 2009, NICE 2011). The Lung Cancer Nurse Specialists (LCNS) and Physiotherapist endeavour to assess all patients pre-operatively following a confirmed or clinical diagnosis of lung cancer and continue this support post-operatively following discharge from the regional Cardiothoracic Centre. Anecdotal evidence suggested that not all patients received the same level of support. Method: A retrospective review of the notes was undertaken of all 24 lung cancer patients who had potentially curative surgery between 1.09.11 and 31.08.12. Conclusion: Results demonstrate that the main reason for not having input from both LCNS and Physiotherapy services is due to ineffective communication between local health care teams and tertiary surgical teams. The results of this audit will form the basis for improving the surgical patient pathway with a view to then examining patient satisfaction through a survey.
Way Forward: Present results of the audit to the local lung cancer team and to the Cardiothoracic team. Develop and agree a clear pathway for surgical patients. Design a fax form to inform the Thoracic CNS of pending patients. Ensure effective timely communication within local team and between healthcare teams. To repeat the audit in a year to evaluate progress. Reference(s) Department of Health (2011) Improving Outcomes: A Strategy for Cancer. London: Department of Health. NICE Guidance (2011): Diagnosis and treatment of Lung Cancer. London: Department of Health. NCAT (2009): Lung Rehabilitation Pathway. National Cancer Action Team. Kings College. London. Department of Health (2010) National Cancer Survivorship Initiative. London: Department of Health. 117 National Lung Cancer Forum For Nurses Supported By Lilly Project 2011/2012 Developing guidance for the supportive and palliative care of lung cancer and mesothelioma patients and their carers A. Richardson1 *, J. Draffan2 , J. White3 . 1 University Hospitals of Leicester NHS Trust, UK, 2 University Hospitals of North Tees, UK, 3 Leeds Teaching Hospitals NHS Trust, UK Lung cancer remains the United Kingdom’s commonest cause of cancer death and accounts for 1 in 14 of UK deaths from all cancers. Approximately 41,428 new cases of lung cancer and 2500 new cases of Mesothelioma are diagnosed in the UK (CRUK: Cancer Research UK, 2009.) Eighty per cent of people will present with advanced disease (NLCA: National Lung Cancer Audit 2010) and the majority of these will die within a year of diagnosis (CRUK 2009). This guidance has been developed over an eighteen month period by a dedicated working party with expertise in caring for lung cancer and mesothelioma patients and carers and incorporating current evidence and guidance The document provides detailed supportive and palliative care specialist interventions to help any health care professional who is caring for a patient with advanced lung cancer or mesothelioma. The guidance is focused around nine key elements that were identified in work carried out by the Health Experience Research Group at the University of Oxford. Cancer patients identified areas of their care that were important to them or that they found to be lacking. Holistic approach to care Getting the bad news Care co ordination Responsiveness and ease of access to benefits and support Inpatient care Pain control and symptom management Staff attitudes and empathy End of life choice and the actual experience Carer focus The guidance discusses each element in relation to lung cancer and mesothelioma patients and carers, makes recommendations for good practice and then gives examples of good practice that have been identified. The aim of the guidance is to provide a usable document with evidence and practice examples to assist health care professionals to improve supportive and palliative care within their area. Reference(s) Cancer Research UK (2009): Incidences of Lung Cancer (online.) Cancer Research UK. Available from: http:/ / www.cancerresearch .org/cancerstats/types/lungincidence (accessed 9th September 2011).