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- Gianluca Catania (Genova, Italy)
Advanced nursing practice in cancer
- Matthew N. Fowler (Birmingham, United Kingdom)
Can we address the problem of the nurses shortage post COVID-19?
- Mark R. Foulkes (Reading, United Kingdom)
Cancer nurses and safety around hazardous drugs, outcome of European Oncology Nursing Society advocacy work
- Helena Ullgren (Solna, Sweden)
CN30 - Three stage capacity: Consent process for systemic anti-cancer therapy
- Fiona E. Barrett (Dublin, Ireland)
Abstract
Background
The decision to undergo systemic anti-cancer therapy by patients with cancer is a complicated process. The decision is based around many variables. Consent requires that a person has the capacity to consent. Medical decision making capacity must include the following attributes: understanding the nature of their cancer, appreciation of the range of potential options, weighing up the pros and cons of each option and the ability to reach a decision that is communicated. We sought to strengthen our approach to the consent process through a “3-stage capacity-consent process”, performed over 3 occasions prior to delivery of the relevant therapy.
Methods
All patients starting a new plan of intravenous therapy were offered participation in the “3-Stage Capacity-Consent Process”. Patients were initially assessed by a senior medical oncologist who discussed the person's cancer, the treatment options & side-effects, predicted outcomes with each approach, and planned an appropriate treatment. On the same day patients were further educated on the aspects of the proposed treatment by a liaison clinical nurse specialist. Within 10 days they were reviewed by a different oncology doctor and a different clinical nurse specialist who answered any questions posed, gave further education and proceeded to the signing of a consent to medical treatment form. On the day of the first dose of treatment patients were once again given the opportunity to ask questions of a doctor and oncology nurse prior to treatment administration.
Results
Between 4/21 and 9/21 126 patients were included in the pilot study. Female patients represented 37% of the cohort. The median age of patients was 65 yrs (range: 20-89). 32% of patients were consented for immunotherapy-related regimens. 13% were having concurrent chemotherapy-radiation therapy. The remaining 55% had cytotoxic chemotherapy. All patients offered the 3-stage process engaged and participated fully in the program.
Conclusions
A 3 stage capacity - consent process is possible, and allows several phases of “information processing time” by patients and their families, ensuring adequate time to show a patient's capacity to be able to consent to their proposed treatment. This pilot approach is being expanded to all patients attending our Cancer Centre.
Legal entity responsible for the study
Beaumont Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
CN32 - Cancer nurses' experiences and perceptions of potential occupational exposure to cytotoxic drugs: Systematic review utilising framework analysis
- Karen Campbell (Edinburgh, United Kingdom)
Abstract
Background
In the UK control of substances Hazardous to Health Regulations (COSHH) define chemotherapy as a hazardous substance. Therefore, it is imperative that employers assess the risk and take suitable precautions for their employees. The ‘
Methods
This review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews and the PRISMA model for organising information. The methodology of Framework analysis was used to underpin the analysis and synthesis for presentation. Registered on Prospero [CRD42022289276].
Results
Ninety papers were identified; 44 full texts were reviewed and 20 papers that met the final inclusion criteria were included in the review. Initial findings were placed in categories of papers and included: personal factors; knowledge of hazards; perceived conflict of interest.
Conclusions
Analysis identified the area of interests to be about team concern when dealing with hazardous chemotherapy instead of being solely an individual pursuit in protecting oneself. This highlights that there is a complex interplay between organisational responsibility, team-efficacy and self-perception of risk based on implementation of guidelines and education.
Legal entity responsible for the study
K. Campbell.
Funding
UK Oncology Nursing Society.
Disclosure
All authors have declared no conflicts of interest.
CN33 - How to work with swiptests in an oncology outpatient ward: An occupational safety project
- Susanne Wallberg (Solna, Sweden)
Abstract
Background
For several years, we have been working to be able to perform swip tests to detect any residues of cytotoxic drugs. The pharmacy prepares all medicines, and infusion tubes contain only sodium chloride. The nurses work in a closed system so that residues of cytostatics do not spread in the department. An important partner in this work is also the patient. Today we have a laboratory that can carry out tests for five different anticancer agents.
Methods
November 2020, the first swip test was performed.11 different surfaces were sampled including medicine room, infusion bag from the pharmacy, desk, floor on the expedition, infusion pump, floor at the patient's place, patient toilet, floor in the corridor, lid on the garbage can, pacto-safe. May 2021a follow-up sampling of surfaces was carried out with an extension of the following surfaces: transport box for the infusion bags from the pharmacy, floors in the staff room, more toilet floors. November 2021 a third sampling was carried out focusing on the floors of the patient toilets.
Results
We got a rash on five surfaces: floors in the patient toilet, floors in the medicine room, below the pacto-safe, floors in the staff room and the infusion bag from the pharmacy .Before the second measurement, we had a review in the working group about our working methods. The cleaning company updated its guidelines regarding personal protective equipment for the cleaners. They also updated the cleaning instructions for the patient toilets. One problem that was identified was that the floors in the patient toilets have anti-slip protection. In the second measurement, cleaning of the patient toilets had been increased from once per day to twice per day. The improvements that had been carried out had the desired effect and we only had rashes on the floors of the patient toilets and on the infusion bag from the pharmacy. Before the third measurement, we expanded the cleaning in the patient toilets.The results showed that we have rashes on the floors of the patient toilets.
Conclusions
The result shows that we have improved the working environment. We have less rash on the surfaces through changed working methods and changed and expanded cleaning routines. The challenge is the floors on the patient toilets.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
CN31 - Project bedside handover 2022 (a tool for health care professionals to increase patient participation in bedside report)
- LACE MATARLO SOLVEBRAND (Solna, Sweden)
Abstract
Background
Breast endocrine tumors and sarcoma unit is a highly specialized cancer care department. Healthcare providers mustconduct care that is patient-centered, therefore it is important to find a way to increase patient participation in clinicalhandover to improve patient care safety. Bedside handover is an evidencebased shift to shift reporting method thatcan help the health care unit to involve patient in its care and promote patient safety awareness. To provide a structured bedside handover, the staff needs a checklist to carry out the bedside report. Bedside handover means thatreporting between shifts in a healthcare facility takes place together with the patient in the bedside (Tan, 2015). The bedside handover method has, resulted in increased patient participation in its care and strengthens the health carestaffs routine for patient safety awareness.
Methods
Information campaigns at meetings, choosing project ambassadors. Checklist, instruktion materials made accessiblefor everyone. The PGSA wheel was performed to follow strategic steps to implement the project. Gibb's reflectioncycle was used to reflect and evaluate the course of the project. Questionnaires for patient and staff was handed out.
Results
In 6 weeks, patients responded to questionnaires about how they experienced bedside handover. According to the survey, patients felt that they were included in the conversation during bedside handover. They also felt safe and felt that they are part of the team. The patient feels that the method of reporting at bedside is great where they felt more involved in their care and become well informed about their care and treatment. They also felt that it was good to know which staff will take over the next shift.
Conclusions
Bedside handover provided a structured patient reporting using a checklist together with the patient. Patient felt like they are involve in their care and help promote patient safety awareness.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.