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Nursing model for a breast cancer unit at the Catalan Institute of Oncology
abstracts CN42
Nursing model for a breast cancer unit at the Catalan Institute of Oncology
A. Rodriguez-Ortega1, T. Ferro2, F.X. Perez3, J.M. Borras4 Breast Unit, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i Reynals), a Hospitalet de Llobregat, Spain, 2Direction of Nursing Care, ICO - Institut Catal d’Oncologia l’Hospitalet (Hospital Duran i Reynals), L’Hospitalet Llobregat, Spain, 3 Clinical Research Unit, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i Reynals), L’Hospitalet Llobregat, Spain, 4Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
1
Disclosure: All authors have declared no conflicts of interest.
CN43
Role of cancer nurse in the prevention and control of acute deterioration for onco-haematologic patient
R. Azor Portole´s1, M. Serra Barril1, S. Cabrera Jaime2, I. Brao Pe´rez3, T. Ferro Garcıa4 Nurse Direccion, Catalan Institute of Oncology. L’Hospitalet, Barcelona, Spain, 2Nurse Direccion, Catalan Institute of Oncology, Barcelona, Spain, 3Nurse Direccion, Catalan Institute of Oncology, Girona, Spain, 4Nurse Direccion, Catalan Institute of Oncology, Barcelona, Spain
1
Background: The Risk of Acute Deterioration (RAD) conceived as the patient status at risk for progression, with severe damage or life-threatening conditions, includes possible progression, emergence or recurrence of serious adverse-events Literature related with physiological parameters such blood pressure, cardiac or respiratory alterations and the capacity for a rapid identification of these RAD as predictors of preventable complications and adverse events The hematological patients with complex processes derived from his tumor, comorbidities and complexity hospitalized, may require admission to Iintensive care or unexpected death. Determine the patient profile that needs prevention and nursing activities and control for the risk of acute deterioration RAD at the centres of the Catalan Institute of Oncology-ICO, for 2018. Methods: Retrospective multicenter cross-sectional study. Scope: 8 oncological units ICO-L’Hospitalet, ICO-Badalona and ICO-Girona. Data obtained from anonymized
v828 | Cancer Nursing: Patient and Occupational Safety
registries system of the electronic clinical history of patients.January to December of 2018. Results: From 6.003 episodes of hospitalized patients, 2.661 contained an indicator of RAD as main nurse diagnostic on register, representing 44.3% of the cases. Observation and intensive surveillance or semi-intensive is fundamental. Nurses’ early identification of RAD and 39.06% needed intensive or semi-surveillance.Total deaths 10.68%. The registration of interventions: systematic control of mental state (77.09%); control of respiratory frequency in 29.14%; simultaneous recording of 5 vital signs (26.60%); 4 vital signs (82.16%); intake/out control (18.67%); record of diuresis (80.86%). Conclusions: Nurses most performed and registered activities were control of heart rate, blood pressure, Sat. O2, temperature, diuresis and mind alert. Low registration for FR, despite being identified as a key intervention in the early identification of RAD and is omitted or is not registered although being prescribed in care plan. Early detection of physiological changes and the identification of patients RAD are need to provide adequate preventive care and treatment and to ensure continued evaluation that avoid deterioration or its consequences. Legal entity responsible for the study: The author. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN44
Standardized nursing care in the department of radiotherapy of a network of cancer centres
J. Delgado1, E. Garcıa2, J. Ribes1, M. Garcıa1, P. Fernandez3 Radiation Oncology, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i a Reynals), Hospitalet de Llobregat, Spain, 2Radiation Oncology, ICO - Institut Catal d’Oncologia l’Hospitalet (Hospital Duran i Reynals), Badalona, Spain, 3Research Department, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i Reynals), Hospitalet de Llobregat, Spain
1
Background: The Catalan Institute of Oncology (ICO) is a specialised cancer institution. It has four centres distributed around Catalonia that covers 45% of the adult cancer patient population in the autonomy. In three of them exists a radiotherapy department: L’Hospitalet, Badalona and Girona; with 11 accelerators altogether. Near 6.000 patients per year receive treatment in them. All radiotherapy departments in Spain need to accomplish with a quality system. ICO has a system based in International Organization for Standardization (ISO) regulations. Recently, a new system of ISO certification (ISO 9001:2015) has required increasing the homogenization level among our three departments. In addition, ICO promotes equality in access to services and assistance. For all these reasons it was developed the “Standardize project of the assistance procedures in Oncologic radiation”. Methods: The ISO whole process was divided in 6 sub processes. In each center there was a group of professionals who works with every sub process and discuss with the other hospitals in order to define the common procedures. In February 2018, we started a work plan to do it through teleconference meetings. Nurses and radiotherapist technicians were included and nominate several leaders in each of the working groups which involved their activity. Meeting works ended in June 2018. From then until 2019 July we run with the implementation time. Results: Nurses and radiotherapist technicians of the three institutions defined the list of agreements and consensus to do: homogeneous written education for patients to implement the active identification with patients Image guided radiotherapy protocols (IGRT) protocols for management break on treatments & short interruptions safety check list for the first session patient follow-up, alternating nurses and physicians nurse appointment at the end of treatments quality indicators for activity & schedules. Conclusions: This project has assured that population from 3 different areas will receive same treatments, under equal circumstances. We incorporated strengths of each centre, using now a unique map of the process of radiotherapy. Furthermore we share same safety and prevention standards and a prospective system for risk analysis. Legal entity responsible for the study: Institut Catala d’Oncologia. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz274.011/5578350 by guest on 25 October 2019
Background: International recommendations for cancer control support the organization of breast cancer care with a multidisciplinary approach in Breast Units (BU). The BU of the Catalan Institute of Oncology (ICO) is a functional unit for breast cancer with oncologists, gynecologists, surgeons and cancer nurses specialized in for diagnosis, treatment and monitoring breast cancer patients. Pathologists and radiologists are also working with the BU. Several international guidelines include nurse as essential part of BU and defined their model of care, management and functions. The objective is to describe care nurse model and activity of the Breast Unit in a cancer center. Methods: Retrospective cross-sectional study. Population cancer patients attended at the BU of the ICO during 2016 to 2017 were included. Variables collected were sociodemographic, clinical - pathology and treatment and nursing interventions for patients. Data was extracted from the clinical record. Data analysis was descriptive using the statistical package SPSS v15. Results: Total of 382 patients. Nursing interventions in patients with early stage breast cancer were: 321 (98.85%) visits before the start of treatments; 322 (99.1%) visits during treatments; 230 (70.8%) visits after finishing treatments; 319 (98.2%) coordination activities for the continuity of care and 136 (14.8%) consultations and derivations to professionals of other services. Nursing interventions in patients with advanced stage breast cancer: 32 (56.1%) visits before the start of treatments; 33 (57.9%) visits during treatments; 17 (29.8%) coordination activities for the continuity of care; and 12 (21.8%) consultations and derivations to professionals of other services. Conclusions: According to this multidisciplinary model of care, patients with breast cancer in the early stages have a high level of clinical contacts with the nurse along the cancer care process. However, there is a high percentage of patients with advanced disease that could not benefit from an early and continued access to nurse. Legal entity responsible for the study: The authors. Funding: Generalitat of Catalonia, Department of Health.
Annals of Oncology
Nursing model for a breast cancer unit at the Catalan Institute of Oncology
A. Rodriguez-Ortega1, T. Ferro2, F.X. Perez3, J.M. Borras4 Breast Unit, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i Reynals), a Hospitalet de Llobregat, Spain, 2Direction of Nursing Care, ICO - Institut Catal d’Oncologia l’Hospitalet (Hospital Duran i Reynals), L’Hospitalet Llobregat, Spain, 3 Clinical Research Unit, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i Reynals), L’Hospitalet Llobregat, Spain, 4Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
1
Disclosure: All authors have declared no conflicts of interest.
CN43
Role of cancer nurse in the prevention and control of acute deterioration for onco-haematologic patient
R. Azor Portole´s1, M. Serra Barril1, S. Cabrera Jaime2, I. Brao Pe´rez3, T. Ferro Garcıa4 Nurse Direccion, Catalan Institute of Oncology. L’Hospitalet, Barcelona, Spain, 2Nurse Direccion, Catalan Institute of Oncology, Barcelona, Spain, 3Nurse Direccion, Catalan Institute of Oncology, Girona, Spain, 4Nurse Direccion, Catalan Institute of Oncology, Barcelona, Spain
1
Background: The Risk of Acute Deterioration (RAD) conceived as the patient status at risk for progression, with severe damage or life-threatening conditions, includes possible progression, emergence or recurrence of serious adverse-events Literature related with physiological parameters such blood pressure, cardiac or respiratory alterations and the capacity for a rapid identification of these RAD as predictors of preventable complications and adverse events The hematological patients with complex processes derived from his tumor, comorbidities and complexity hospitalized, may require admission to Iintensive care or unexpected death. Determine the patient profile that needs prevention and nursing activities and control for the risk of acute deterioration RAD at the centres of the Catalan Institute of Oncology-ICO, for 2018. Methods: Retrospective multicenter cross-sectional study. Scope: 8 oncological units ICO-L’Hospitalet, ICO-Badalona and ICO-Girona. Data obtained from anonymized
v828 | Cancer Nursing: Patient and Occupational Safety
registries system of the electronic clinical history of patients.January to December of 2018. Results: From 6.003 episodes of hospitalized patients, 2.661 contained an indicator of RAD as main nurse diagnostic on register, representing 44.3% of the cases. Observation and intensive surveillance or semi-intensive is fundamental. Nurses’ early identification of RAD and 39.06% needed intensive or semi-surveillance.Total deaths 10.68%. The registration of interventions: systematic control of mental state (77.09%); control of respiratory frequency in 29.14%; simultaneous recording of 5 vital signs (26.60%); 4 vital signs (82.16%); intake/out control (18.67%); record of diuresis (80.86%). Conclusions: Nurses most performed and registered activities were control of heart rate, blood pressure, Sat. O2, temperature, diuresis and mind alert. Low registration for FR, despite being identified as a key intervention in the early identification of RAD and is omitted or is not registered although being prescribed in care plan. Early detection of physiological changes and the identification of patients RAD are need to provide adequate preventive care and treatment and to ensure continued evaluation that avoid deterioration or its consequences. Legal entity responsible for the study: The author. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN44
Standardized nursing care in the department of radiotherapy of a network of cancer centres
J. Delgado1, E. Garcıa2, J. Ribes1, M. Garcıa1, P. Fernandez3 Radiation Oncology, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i a Reynals), Hospitalet de Llobregat, Spain, 2Radiation Oncology, ICO - Institut Catal d’Oncologia l’Hospitalet (Hospital Duran i Reynals), Badalona, Spain, 3Research Department, ICO - Institut Catal a d’Oncologia l’Hospitalet (Hospital Duran i Reynals), Hospitalet de Llobregat, Spain
1
Background: The Catalan Institute of Oncology (ICO) is a specialised cancer institution. It has four centres distributed around Catalonia that covers 45% of the adult cancer patient population in the autonomy. In three of them exists a radiotherapy department: L’Hospitalet, Badalona and Girona; with 11 accelerators altogether. Near 6.000 patients per year receive treatment in them. All radiotherapy departments in Spain need to accomplish with a quality system. ICO has a system based in International Organization for Standardization (ISO) regulations. Recently, a new system of ISO certification (ISO 9001:2015) has required increasing the homogenization level among our three departments. In addition, ICO promotes equality in access to services and assistance. For all these reasons it was developed the “Standardize project of the assistance procedures in Oncologic radiation”. Methods: The ISO whole process was divided in 6 sub processes. In each center there was a group of professionals who works with every sub process and discuss with the other hospitals in order to define the common procedures. In February 2018, we started a work plan to do it through teleconference meetings. Nurses and radiotherapist technicians were included and nominate several leaders in each of the working groups which involved their activity. Meeting works ended in June 2018. From then until 2019 July we run with the implementation time. Results: Nurses and radiotherapist technicians of the three institutions defined the list of agreements and consensus to do: homogeneous written education for patients to implement the active identification with patients Image guided radiotherapy protocols (IGRT) protocols for management break on treatments & short interruptions safety check list for the first session patient follow-up, alternating nurses and physicians nurse appointment at the end of treatments quality indicators for activity & schedules. Conclusions: This project has assured that population from 3 different areas will receive same treatments, under equal circumstances. We incorporated strengths of each centre, using now a unique map of the process of radiotherapy. Furthermore we share same safety and prevention standards and a prospective system for risk analysis. Legal entity responsible for the study: Institut Catala d’Oncologia. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Volume 30 | Supplement 5 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz274.011/5578350 by guest on 25 October 2019
Background: International recommendations for cancer control support the organization of breast cancer care with a multidisciplinary approach in Breast Units (BU). The BU of the Catalan Institute of Oncology (ICO) is a functional unit for breast cancer with oncologists, gynecologists, surgeons and cancer nurses specialized in for diagnosis, treatment and monitoring breast cancer patients. Pathologists and radiologists are also working with the BU. Several international guidelines include nurse as essential part of BU and defined their model of care, management and functions. The objective is to describe care nurse model and activity of the Breast Unit in a cancer center. Methods: Retrospective cross-sectional study. Population cancer patients attended at the BU of the ICO during 2016 to 2017 were included. Variables collected were sociodemographic, clinical - pathology and treatment and nursing interventions for patients. Data was extracted from the clinical record. Data analysis was descriptive using the statistical package SPSS v15. Results: Total of 382 patients. Nursing interventions in patients with early stage breast cancer were: 321 (98.85%) visits before the start of treatments; 322 (99.1%) visits during treatments; 230 (70.8%) visits after finishing treatments; 319 (98.2%) coordination activities for the continuity of care and 136 (14.8%) consultations and derivations to professionals of other services. Nursing interventions in patients with advanced stage breast cancer: 32 (56.1%) visits before the start of treatments; 33 (57.9%) visits during treatments; 17 (29.8%) coordination activities for the continuity of care; and 12 (21.8%) consultations and derivations to professionals of other services. Conclusions: According to this multidisciplinary model of care, patients with breast cancer in the early stages have a high level of clinical contacts with the nurse along the cancer care process. However, there is a high percentage of patients with advanced disease that could not benefit from an early and continued access to nurse. Legal entity responsible for the study: The authors. Funding: Generalitat of Catalonia, Department of Health.
Annals of Oncology