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P51 Oncology nursing care and patient education of substandard drugs
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Abstracts and learning outcomes / European Journal of Oncology Nursing 14S1 (2010) S1–S62
Results: The multidisciplinary team has developed a care-pathway in association with the hospital-unit. The care-pathway describes agreements and existing protocols. Per day is described how the patient care must be arranged. By means of re-measuring in comparison with the baseline measuring, it showed that the extent of new-care products results in faster convalescence and dismissal of the patient. The harmonization of care caused a lot of improvements: every discipline involved knows his tasks and the tasks of the other disciplines. Unnecessary duplications of tasks have been removed. There have been task-shifts from surgeon to nurse, and from physiotherapist to nurse. The role of the general practitioner in the homecare-situation improved through better information. Also the care has been arranged to the newest insights and on swift action in informing the patient, and mobilizing the patient after surgery. Unnecessary care attributions, such as spraying, have been abolished. Conclusions: A good developed care-pathway provides insights in activities of the disciplines involved in the care around the lung surgery patient. It can lead to task-reorganization, improves the quality of the care and leads to faster convalescence and dismissal of the patient. Because of the care-pathway the fulfilment of the team has increased. Also the satisfaction of the patient has improved. P51 Oncology nursing care and patient education of substandard drugs B. Liang. CWSL Institute of Health Law Studies, UCSD San Diego Centre for Patient Safety, San Diego, California, USA Introduction: Cancer patients often obtain substantive medication information only from oncology nurses. However, substandard drugs are not a topic that is usually discussed. This work investigates the potential for substandard drugs, including potential sources, legal, and policy concerns to determine if it warrants oncology nursing discussion with patients. Methods: Analysis of legal and policy infrastructures that ensure safety of the international drug supply and pharmacoepidemiologic review of confidential industry databases on substandard drug prevalence. Results and Discussion: Parallel trade, which allows drugs to easily move between countries, Internet sourcing, and a robust globalized counterfeit drug industry creates significant risks of substandard drugs. Government policies that either promotes parallel trade (e.g., EU, Asia) and tacit approval and limited regulation (e.g., USA) result in little effective oversight. Policy accountability for Internetsourced drugs – a primary source of substandard and counterfeit medications – is nonexistent due to jurisdictional issues and limited international cooperation. Importantly, pharmacoepidemiological analysis indicates fake and substandard drugs are rampant and are not limited to lifestyle drugs, but encompass lifesaving drugs including oncology treatments such as erythropoietin and filgrastim, through drugs provided for pain management in cancer care, such as opiates. Oncology nurses must educate their patients and themselves about the risks of substandard drugs, including the types, sources, and scope of the problem, and be vigilant about this possibility when therapeutic failure in cancer treatment occurs. Conclusion: Substandard drugs exist widely, and government policies and laws provide limited protection. Oncology nurses must understand the risks, have a high index of suspicion if therapeutic failure occurs, and educate patients on this important clinical issue. P52 Management of sexual dysfunction in breast cancer H. Bektas1 , I. Ozkan. Akdeniz University, Antalya School of Health, Antalya, Turkey Breast cancer and its treatment can change the way a woman thinks and feels about her whole body, her femininity, her self
esteem and the way she behaves. The treatment of breast cancer with chemotherapy or hormonal therapy may also affect self image, fertility and libido. Loss of hair and early menopause may constitute a serious threat to a woman’s image of herself. Due to the sensitive nature of the topic, many patients are not reluctant to discuss sexual difficulties with health care providers or to seek help for these problems. This process should begin at the initiation of treatment and should be continued as treatment is completed. The majority of findings suggest that psychological interventions improve the emotional adjustment and social functioning of women with cancer. These interventions can include cognitive behaviour therapy, psychotherapy, psychoeducational therapy, group therapy and family therapy. Health professionals need to convey support, empathy and listen actively. Interviewing patients and their partners can also be of value in determining how best to support and help couples through the traumatic experience. Oncology professionals should initiate communication about sexual difficulties, perform comprehensive assessments, and educate and counsel patients about the management of these difficulties. Patient education and reassurance, with early diagnosis and intervention, are essential for effective treatment. Patient history and physical examination techniques, normal sexual responses and the factors that influence these responses and the application of medical and gynaecologic treatments to sexual issues are important. Breast cancer patients with problems of sexual desire and difficulty achieving orgasm may benefit from psychotherapy to tease out physical, psychological, and interpersonal factors contributing to the problem. Behavioural recommendations include specifying sexual practices for health promotion purposes compared to those for pleasure or arousal, use of other sources of stimulation for pleasure, and use of relaxation techniques to help alleviate sexual difficulties. Individual or couples therapy for sexual dysfunction is best conducted by a mental health professional with specialized training in an empirically-supported form of sex therapy. After treatment, it is important for the health professional to explore sensitively about body image, sexuality and the sexual relationship rather than wait for the woman to bring up these issues. Giving this information to couples gives them the permission to talk about the impact of the illness on their sexuality or the couple relationship. However, this may not always be suitable for all patients. P53 Assessing Hellenic oncology nurses’ knowledge and practice about chemotherapy handling and administration D. Papa1 , A. Kampitsi1 , S. Katsaragakis1 , C. Leventelis1 , D. Papageorgiou1 , A. Papadouri1 . 1 Hellenic Oncology Nursing Society, Nursing, Athens, Greece Introduction: As the preparation and administration of chemotherapy agents is primarily the nurse’s responsibility, the nurse should be knowledgeable about proper procedures for drug preparation, handling and methods of drug delivery. The purpose of this correlation descriptive study of the Hellenic oncology nursing society was to investigate Hellenic oncology nurses’ practices and knowledge about chemotherapy handling and administration. Material and Methods: Study sample was consisted of registered nurses (N = 70) working in oncology hospitals and oncology wards of general hospitals. A study instrument of 23 items exploring nurses’ practice and knowledge about chemotherapy handling and administration safety measures was developed by the investigators. The instrument had appropriate psychometric characteristics. Results and Discussion: The majority of nurses were female (91.4%), 36–45 years old (53.2%) and had a bachelor in nursing (75.7%). They worked as clinical nurse (55.7%) in an oncology (40%) or internal medicine ward (25.7%). Most of them reported that they only administered chemotherapy (74.3%). A small percentage (20%) reported that they mixed, prepared and also administered
Abstracts and learning outcomes / European Journal of Oncology Nursing 14S1 (2010) S1–S62
Results: The multidisciplinary team has developed a care-pathway in association with the hospital-unit. The care-pathway describes agreements and existing protocols. Per day is described how the patient care must be arranged. By means of re-measuring in comparison with the baseline measuring, it showed that the extent of new-care products results in faster convalescence and dismissal of the patient. The harmonization of care caused a lot of improvements: every discipline involved knows his tasks and the tasks of the other disciplines. Unnecessary duplications of tasks have been removed. There have been task-shifts from surgeon to nurse, and from physiotherapist to nurse. The role of the general practitioner in the homecare-situation improved through better information. Also the care has been arranged to the newest insights and on swift action in informing the patient, and mobilizing the patient after surgery. Unnecessary care attributions, such as spraying, have been abolished. Conclusions: A good developed care-pathway provides insights in activities of the disciplines involved in the care around the lung surgery patient. It can lead to task-reorganization, improves the quality of the care and leads to faster convalescence and dismissal of the patient. Because of the care-pathway the fulfilment of the team has increased. Also the satisfaction of the patient has improved. P51 Oncology nursing care and patient education of substandard drugs B. Liang. CWSL Institute of Health Law Studies, UCSD San Diego Centre for Patient Safety, San Diego, California, USA Introduction: Cancer patients often obtain substantive medication information only from oncology nurses. However, substandard drugs are not a topic that is usually discussed. This work investigates the potential for substandard drugs, including potential sources, legal, and policy concerns to determine if it warrants oncology nursing discussion with patients. Methods: Analysis of legal and policy infrastructures that ensure safety of the international drug supply and pharmacoepidemiologic review of confidential industry databases on substandard drug prevalence. Results and Discussion: Parallel trade, which allows drugs to easily move between countries, Internet sourcing, and a robust globalized counterfeit drug industry creates significant risks of substandard drugs. Government policies that either promotes parallel trade (e.g., EU, Asia) and tacit approval and limited regulation (e.g., USA) result in little effective oversight. Policy accountability for Internetsourced drugs – a primary source of substandard and counterfeit medications – is nonexistent due to jurisdictional issues and limited international cooperation. Importantly, pharmacoepidemiological analysis indicates fake and substandard drugs are rampant and are not limited to lifestyle drugs, but encompass lifesaving drugs including oncology treatments such as erythropoietin and filgrastim, through drugs provided for pain management in cancer care, such as opiates. Oncology nurses must educate their patients and themselves about the risks of substandard drugs, including the types, sources, and scope of the problem, and be vigilant about this possibility when therapeutic failure in cancer treatment occurs. Conclusion: Substandard drugs exist widely, and government policies and laws provide limited protection. Oncology nurses must understand the risks, have a high index of suspicion if therapeutic failure occurs, and educate patients on this important clinical issue. P52 Management of sexual dysfunction in breast cancer H. Bektas1 , I. Ozkan. Akdeniz University, Antalya School of Health, Antalya, Turkey Breast cancer and its treatment can change the way a woman thinks and feels about her whole body, her femininity, her self
esteem and the way she behaves. The treatment of breast cancer with chemotherapy or hormonal therapy may also affect self image, fertility and libido. Loss of hair and early menopause may constitute a serious threat to a woman’s image of herself. Due to the sensitive nature of the topic, many patients are not reluctant to discuss sexual difficulties with health care providers or to seek help for these problems. This process should begin at the initiation of treatment and should be continued as treatment is completed. The majority of findings suggest that psychological interventions improve the emotional adjustment and social functioning of women with cancer. These interventions can include cognitive behaviour therapy, psychotherapy, psychoeducational therapy, group therapy and family therapy. Health professionals need to convey support, empathy and listen actively. Interviewing patients and their partners can also be of value in determining how best to support and help couples through the traumatic experience. Oncology professionals should initiate communication about sexual difficulties, perform comprehensive assessments, and educate and counsel patients about the management of these difficulties. Patient education and reassurance, with early diagnosis and intervention, are essential for effective treatment. Patient history and physical examination techniques, normal sexual responses and the factors that influence these responses and the application of medical and gynaecologic treatments to sexual issues are important. Breast cancer patients with problems of sexual desire and difficulty achieving orgasm may benefit from psychotherapy to tease out physical, psychological, and interpersonal factors contributing to the problem. Behavioural recommendations include specifying sexual practices for health promotion purposes compared to those for pleasure or arousal, use of other sources of stimulation for pleasure, and use of relaxation techniques to help alleviate sexual difficulties. Individual or couples therapy for sexual dysfunction is best conducted by a mental health professional with specialized training in an empirically-supported form of sex therapy. After treatment, it is important for the health professional to explore sensitively about body image, sexuality and the sexual relationship rather than wait for the woman to bring up these issues. Giving this information to couples gives them the permission to talk about the impact of the illness on their sexuality or the couple relationship. However, this may not always be suitable for all patients. P53 Assessing Hellenic oncology nurses’ knowledge and practice about chemotherapy handling and administration D. Papa1 , A. Kampitsi1 , S. Katsaragakis1 , C. Leventelis1 , D. Papageorgiou1 , A. Papadouri1 . 1 Hellenic Oncology Nursing Society, Nursing, Athens, Greece Introduction: As the preparation and administration of chemotherapy agents is primarily the nurse’s responsibility, the nurse should be knowledgeable about proper procedures for drug preparation, handling and methods of drug delivery. The purpose of this correlation descriptive study of the Hellenic oncology nursing society was to investigate Hellenic oncology nurses’ practices and knowledge about chemotherapy handling and administration. Material and Methods: Study sample was consisted of registered nurses (N = 70) working in oncology hospitals and oncology wards of general hospitals. A study instrument of 23 items exploring nurses’ practice and knowledge about chemotherapy handling and administration safety measures was developed by the investigators. The instrument had appropriate psychometric characteristics. Results and Discussion: The majority of nurses were female (91.4%), 36–45 years old (53.2%) and had a bachelor in nursing (75.7%). They worked as clinical nurse (55.7%) in an oncology (40%) or internal medicine ward (25.7%). Most of them reported that they only administered chemotherapy (74.3%). A small percentage (20%) reported that they mixed, prepared and also administered