program book
Pullman Albert Park, Melbourne
major supporters
contents
Welcome 3 Concurrent Session C: Evidence Based Practice 23
Supporters & Partners 4 A natural oil-based emulsion containing allantoin versus aqueous cream for managing radiodermatitis in patients Committees 5 with cancer: A phase III double-blind randomised controlled trial 23 Getting Social 8 attitudes amongst Australian cancer nurses 24 Congress Information 9 Acute transfusion reaction knowledge and Room Allocations 10 management – How well are we doing? 24 Speeding to zero: A nurse led project to reduce central Floor Plans 11 Exhibition and exhibition opening hours 12 oncology inpatients 25 Program 14 Randomised controlled trials of an energy conservation and management intervention for cancer-related fatigue Poster Listing 17 in men treated for prostate cancer 25 Breakfast Session 1: The Chris O’Brien Lifehouse Implementation Experience 18 Breakfast Session 2: Optimising supportive care in Men get breast cancer too: An information resource for immuno-oncology: The VOYCE nurses network 18 men with breast cancer 26 A Melbourne based nursing perspective on advanced Plenary Session 1 18 breast cancer (ABC) supportive care: Is ABC as easy Leading in a time of change: Improving cancer services as 1, 2, 3? 26 using experienced based co-design methodology 18 The role of the Australian breast care nurse: The metamorphosis of melanoma from forgotten disease A self-report online survey 27 to poster child 19 Enhanced surveillance of gestational breast cancer 27 Concurrent Session A: Models of Care (a) 19 breast cancer: An information resource for partners of Epworth Healthcare Leadership Programs: women with breast cancer 28 Developing nurse leaders 19 The New Zealand Cancer Nurse Coordinator initiative: Concurrent Session E: Education for Nurses (b) 28 Establishing a new model of nursing care 19 Eliciting key clinical information – What to ask and why Finding the key to the lock: Development of the access in Radiotherapy 28 co-ordinator role in a cancer imaging department 20 EVIQ education – Supporting best practice through The development of the cancer nurse practitioner role patient focused evidenced based radiation oncology in Australia: A qualitative study 20 modules 28 Measuring what matters: Quantifying the activity of The effect of language on cancer nursing practice 29 radiotherapy nurses in a patient centred model of care 21 EVIQ Bridging the Gap – Real-time evidence retrieval using a bibliometrics solution 29 Concurrent Session B: Education for Nurses (a) 21 Queensland’s extension of EDCAN to Queensland-Cancer An evaluation of registered nurses’ oral cryotherapy Education Program (Q-CEP) 30 Concurrent Session F: Survivorship 30 ADAC – Standardising skills for all clinical staff 22 Nurse-lead survivorship clinic in practice 30 Leading in a time of change – Preparing nurses for the Women’s experience of breast care nurses in a future of the deadly dust 22 survivorship clinic 31 Intrathecal pain management: Development of a Helping indigenous people with cancer to better self-directed learning package 22 navigate towards optimal care: A pilot study 31 A quasi experimental randomised controlled trial utilising Developing a rehabilitation framework for a translational research intervention to improve cancer cancer survivorship 31 nurses adherence with recommended pain screening Breaking down the barriers: Examination of the barriers and assessment practices 23 to psychological screening and referral of men with chronic illness displaying signs of distress 32
1 17th winter congress contents
Plenary Session 2 32 Expanding the scope of practice of the enrolled nurses to Dressing and securement options for central venous access include administration of antineoplastic agents: Key issues devices: Do they work, or are they just more work?! 32 and recommendations of the CNSA education committee 41 Facing an uncertain future: Cancer care in the era of “Let’s talk about sex” – The implementation of a nurse antimicrobial resistance 33 practitioner (NP) led sexual health and erectile dysfunction (SHED) clinic at Peter MacCallum Cancer Centre (Peter Mac) 42 Plenary Session 3 34 How do prostate cancer specialist nurses’ professional Improving the patient journey through better mental health development needs change over time? 42 care: Core business for all nurses 34 Plenary Session 4 43 Cancer Care in Indigenous communities, with advances in personalised medicine are we closing the gap in health Developing community pathways for people living with and outcomes? 34 beyond cancer 43
Concurrent Session G: Education for Patients 34 Poster Abstracts 44 “RESILIENCE” support group model: A tailored information 1. A severe docetaxel skin reaction: A case report 44 and peer support program for women newly diagnosed with 2. Co-ordination of supportive care needs in metastatic ovarian cancer and their carers 35 breast cancer 44 Cancer Council Helpline – How many people use this 3. Promoting awareness in quality radiotherapy nursing 44 information and support service and why not? 35 4. My journey as a novice researcher: A journey worth taking! 45 Using web-enabled technology to support men with prostate 5. Peripherally inserted central catheter (PICC) cushioning cancer 36 material: A pilot study comparing gauze with silicone foam The development and evaluation of resources for friends of for chemotherapy patients 45 young people living with cancer 36 6. Crowning Glory – Is that the whole story? Implementing A shift in paradigm – Central Integrated Regional Cancer scalp cooling in an Australian setting 46 Service (CIRCS) Cancer Education Program 37 7. Psychosocial nursing interventions for patients with cancer 46 8. Who are today’s leaders? 47 Concurrent Session H: Supportive Care 37 9. Piccs, ports and peripheral cannulas – The patients’ The role of team leader in promoting supportive care screening perspective 47 among cancer nurses 37 Distress screening and supportive care needs of cancer beyond the bedside 47 patients and carers in regional western Australia 38 11. Extending the scope of practice of an endorsed enrolled Digital information service and cancer supportive care: nurse in a chemotherapy day unit ... What can they do? 48 A Victorian perspective 38 12. Dabrafenib, a new era – Targeted therapies and Same same but different: Comparison of oncology nurses side-effects 48 family practices in Australia and Denmark 38 13. Online patient-held resources for improving cancer pain The implications of the withdrawal of the Liverpool Care management 49 Pathway in the UK for Australia: A discussion paper 39 14. Nurse care guides – A communication, education and Evaluation of the gynaecology basic sexual health assessment documentation tool 49 questions included in the supportive needs screening tool 39 15. The establishment of chemo@home – An integrated Concurrent Session I: Models of Care (b) 40 model of patient centred service delivery for chemotherapy patients 50 Western Health Oncology Hospital in the home: Issues for 16. Development and implementation of Australian consensus home-based cancer treatment 40 guidelines for the safe handling and administration of monoclonal antibodies for cancer treatment by healthcare Innovative nursing workforce strategy.... Incorporating an personnel 50 endorsed enrolled nurse into a chemotherapy day unit 40 17. Urgent care of the oncology patient – Analysis from a Improving cancer symptom and chemotherapy toxicity cross sectional study of the clinical characteristics of oncology management for patients undergoing chemotherapy at patients presenting to one Sydney tertiary referral emergency Western Health 41 department 51
2 cancer nursing: leading in a time of change contents
18. Professional challenges and support mechanisms for breast care nurses in rural and remote Queensland 51 Travel Grant Recipients 55 19. A tablet a day? Introducing a mobile electronic device into home based cancer care 52 Notes 55 20. Ipilimumab: The importance of nursing education and patient assessment 52
welcometo melbourne On behalf of the Local Organising Committee I would like to Please also make sure you leave yourself enough time to look welcome you to the 17th Annual CNSA Winter Congress. This at the great display of posters. year’s congress will be a time to learn, discuss, debate and We are very grateful to our industry supporters, without them this congress would not be possible. Please visit them and see and what the future holds for Cancer Nursing. The foci for 2014 the latest products and resources they have to offer. This year will incorporate the evolution in nursing leadership, evidence based treatments and patient centred care, including change, these organisations continue to provide invaluable information for our patients and support for us as Cancer Nurses. This year we welcome Dr Theresa Wiseman from The Royal Marsden NHS Foundation Trust, UK as our international shopping! If you want to get out and explore the city a member speaker, who along with our renowned national speakers will of the Local Organising Committee will be more than happy to set the tone for a fantastic congress. point you in the right direction. We have planned this congress so there are relevant sessions We hope that this congress will be informative and thought for all delegates attending. Make sure you make the most of provoking and that you will gain valuable information that you this program so that you can select the concurrent sessions can put into practice. that are right for you. Jac Mathieson
3 17th winter congress supporters & partners
major supporters
congress partners
breakfast session supporters
4 cancer nursing: leading in a time of change supporters & partners
Pre-Congress Workshop supporters
phone app supporter Note Pads and Pens supporter
committees
Winter Congress Committee National Executive Committee President: Sandy McKiernan President Elect: Raymond Chan Secretary, Website and Membership Coordinator: Anne Mellon Treasurer: Trevor Saunders SA Representative: Nicole Loft QLD Representative: Local Organising Committee NSW Representative/RG Coordinator: Ellen Barlow VIC Representative: TAS Representative/SIG Coordinator: Laura Pyszkowski WA Representative: Samantha Gibson CNSA Administration Assistant: Amy Ribbons 5 17th winter congress speaker profiles
international keynote speaker Professor Grant McArthur Dr Theresa Wiseman Professor Grant McArthur Dr Theresa Wiseman is Lead is a Fellow of the Royal for Health Service Research, Australasian College of Nursing, Rehabilitation and Physicians and holds a PhD Quality, at The Royal Marsden in Medical Biology. In 2004 he NHS Foundation Trust, was awarded the Translational London UK. Dr Wiseman was Research Award of the a lead investigator on the Fondation Nelia et Amadeo Barletta and presented a internationally acclaimed work plenary paper at the EORTC-NCI-ACCR Symposium on Evidence Based Co-Design, an innovative and on Molecular Targets and Cancer Therapeutics. In uniquely patient-centred approach to improving UK 2005 he was awarded the Sir Edward Dunlop Clinical health services provision. She has recently completed Cancer Research Fellowship of the Cancer Council an analysis of the UK Patient Experience Survey of Victoria. He is national and international study co- and has experience and expertise in developing chair of a number of clinical trials of targeted therapies. interventions and care pathways to respond to Research Interests include clinical trials of targeted patient experience. Dr Wiseman has an impressive therapeutics, molecular haematology, melanoma, cell cycle control, differentiation, and functional imaging. was responsible for developing the 10 Top Tips as He is an associate editor for melanoma at Annals part of the Macmillan National Cancer Survivorship of Oncology and sits on the editorial board of Anti Initiative funded Consequences of Cancer and Treatment Collaborative, which is distributed widely throughout the UK. invited speakers Associate Professor Gail Garvey Nature Cell Biology. Associate Professor Gail Garvey, a Kamilaroi woman Professor Claire from New South Wales and Rickard Senior Research Fellow at Professor Claire Rickard is Menzies School of Health from the NHMRC Centre Research has 25 years for Research Excellence in experience working in Indigenous education and health research. She plays a leadership role in Indigenous cancer research, She believes a randomised advocates involving Indigenous stakeholders and controlled trial is a thing of clinicians to achieve maximum impact from research beauty and its joys last forever. Rickard attempts and has an impressive record in research capacity- to apply that beauty and joy to improve the care building. of the 70-90% of all hospital patients who need an intravascular access device for treatment. Rickard is Director of the Australian Vascular Access Teaching TT, a Centre of Research Excellence in Indigenous and Research (AVATAR) Group, a group of more Cancer and a Cancer Council NSW Strategic than 100 clinical and academic researchers working Research Partnership Grant. These programs towards making intravascular device complications investigate system approaches to service delivery history. The National Health and Medical Research and interventions to improve cancer outcomes for Council have funded her work with more than $6 Aboriginal and Torres Strait Islander people. million. With over 100 published papers, including in Indigenous Cancer Network (NICaN) in partnership recommendations including the safety of removing with Australian Indigenous HealthInfoNet, Cancer peripheral intravenous catheters based on clinically- Council Australia and The Lowitja Institute. NICaN based rather than time-based criteria. Prof Rickard aims to encourage and support collaboration around was inducted into the prestigious STTI International research and services for Indigenous people with Nurse Researcher Hall of Fame in 2012 in Prague. cancer, their carers and families.
6 cancer nursing: leading in a time of change speaker profiles
Adjunct Associate Professor Associate Professor Karin Kim Ryan Thursky Adjunct Associate Professor Kim Associate Professor Karin Thursky is Ryan, Credentialed Mental Health an Infectious Diseases physician with Nurse and CEO, Australian College of appointments at Royal Melbourne Mental Health Nurses Hospital and Peter MacCallum Cancer Centre and is an honorary fellow Adjunct Associate Professor Ryan with the University of Melbourne Medical School. She is actively involved in the area of quality and safety and has a national commencing in the position in 2004. The ACMHN is the peak professional mental health nursing organisation and the implementation of consensus guidelines for the prevention recognised Credentialing body for mental health nurses in and treatment of infections in the cancer patient. Her research Australia. She is passionate about mental health and mental area is broad with interests such as clinical epidemiology of health nursing holding a more prominent position on health infections in the immunocompromised host, health economics, agendas at local, state, national and international levels and computerised decision support, natural language processing believes this can only be achieved with a strong, united, and surveillance. professional voice. She is a Board member of the Mental Health Professionals Network (MHPN), a member of the governing council of the Coalition of National Nursing Organisations. She was awarded the position of Adjunct Associate Professor by Sydney University in 2009 in recognition of her contribution to the nursing profession.
WE MEASURE our SUCCESS IN HAEMATOLOGY BY your SUCCESS
Celgene Pty Ltd ABN 42 118 998 771. Level 7, 607 St Kilda Rd, Melbourne VIC 3004, Australia. Tel 1800 CELGENE (1800 235 4363) www.celgene.com.au EMVREV0100 Last revised: June 2014
7 17th winter congress getting social with winter congress
If you have a Twitter or Facebook account, you can join in on the conversation at this years’ Winter Congress. CNSA_ORG and Facebook page Facebook/CNSA.org will be talking about session highlights and speaker topics, as well as getting interactive and responding to your tweets and questions.
Show me the hashtag ... our dedicated hashtag #cnsa2014 in your tweets and your Facebook posts. Using the hashtag will help the organising committee, speakers questions.
More than words ... But it doesn’t just have to be about words, we would love to see your photos of the experience you are having at the Winter Congress. Share your photos on Facebook using #cnsa2014 – the best ones
Share the love ... It’s also good to share – so if you see a tweet or a Facebook post from CNSA that you agree with or like then click the share button or the re-tweet button and let all everyone know that you’re involved with the 2014 Winter Congress.
Need help? Chilli Fox’s friendly staff members are available throughout the congress to help you get social with CNSA Winter Congress on Twitter and Facebook. Visit them at the registration desk for anything “social media” related.
facebook.com/CNSA.ORG
Join the conversation #CNSA2014
8 cancer nursing: leading in a time of change congress information
Social Program Information Congress Message Board Welcome Reception There will be a message board located adjacent to the registration desk for delegates wishing to communicate with colleagues. The Congress Gala Dinner list of attendees will Pullman Albert Park – Exhibition Area also be displayed on the board. The Welcome Reception is included in the registration fee for full registrants and includes canapés and drinks. Attendance Certificates Dress: Smart Casual Congress Gala Dinner post congress. For delegates attending a pre-congress workshop you attended and this will also be emailed to the The Ballroom, Pullman Albert Park email address you nominated at registration. Dress: Dress to impress! Ticket price: Speaker Preparation Room cooking stations, drinks and entertainment. All presenters must check-in at the Speakers’ Preparation This is a ticketed event, should you wish to purchase a ticket or room (Room M8) at least 2 hours prior to the start of their if you have selected to attend but no longer wish to then please session time. Presentations must be brought on either USB contact the Registration Desk immediately. memory stick or CD.
REGISTRATION DESK Poster Display The registration desk will be located on level one of the hotel, The poster display will be located within the exhibition area on within the exhibition area. The opening times are as follows: level one of the hotel. Thursday 24 July: 3.00pm – 6.30pm Friday 25 July: 7.00am – 5.00pm score card located in your name badge pocket. Please hand 8.00am – 4.00pm this in to the registration desk no later than lunch time on Registration Entitlements Saturday. sessions, the congress satchel, abstract book, attendance Business Centre Business services, such as photocopying, printing and faxing & afternoon teas, lunches on each day of the congress and is available from “Conference Concierge” which is located on level one of the hotel. Internet Access electronically post congress), morning and afternoon tea Wireless internet is available to congress delegates and is and lunch on the day of registration designed for web browsing and checking web based email. Catering Break Times code. Computer terminals are also available on the ground Morning, afternoon tea and lunch will be served within the congress exhibition area which is located on level one of the hotel. Friday 25 July Getting around 10.20am – 10.50am Morning Tea Trams: Trams travel down St Kilda Rd (numbers 3, 5, 6, 16, 64 and 67). Tram stop 27 is the closest to The Pullman Albert 12.30pm – 1.30pm Lunch Park and is a short walk down Lorne Street to the hotel. 3.10pm – 3.40pm Afternoon Tea Trains: The closest train stations to the hotel are Prahran (located on the corner of Greville Street and Porter Street), 10.40am – 11.20am Morning Tea and Flinders Street. 1.20pm – 2.20pm Lunch Buses: The closest bus stop to the hotel is located at the corner of Greville Street and Punt Road, Prahran. The stop ID Dietary Requirements number is 1115. If you have not already done so, please advise the Congress Myki smartcards can be purchased to travel on trams, trains allergies. If you have advised of a special diet request, please make yourself known to banqueting staff in order to collect visitor packs and public transport victoria. your special meal. Please note that vegetarians will be catered Taxis: The hotel is able to order you a taxi upon request, for as standard. however you can also catch a taxi from designated taxi ranks. 9 17th winter congress room allocations
thursday 24 july Pre-Congress Workshop 1 Lake Rooms 1 & 2 Pre-Congress Workshop 2 Lake Rooms 3 & 4 Pre-Congress Workshop 3 Element Room Pre-Congress Workshop 4 Park Room Welcome Reception Exhibition Area – Grand Ballroom
friday 25 july Breakfast Session 1 – Hospira Lake Room Breakfast Session 2 – BMS Element Room Plenary Session 1 Grand Ballroom 1 – 4 Concurrent Session A Grand Ballroom 1 & 2 Concurrent Session B Grand Ballroom 3 Concurrent Session C Grand Ballroom 4 Breast SIG Meeting Grand Ballroom 1 & 2 Gynae-Oncology SIG Meeting Grand Ballroom 3 Radiation Oncology SIG Meeting Grand Ballroom 4 Concurrent Session D Grand Ballroom 1 & 2 Concurrent Session E Grand Ballroom 3 Concurrent Session F Grand Ballroom 4 Plenary Session 2 Grand Ballroom 1 – 4 Gala Dinner Grand Ballroom 1 & 2
Saturday 26 July CNSA Education Committee Breakfast Meeting M10 Plenary Session 3 Grand Ballroom 1 – 4 CNSA AGM Grand Ballroom 1 – 4 Concurrent Session G Grand Ballroom 1 & 2 Concurrent Session H Grand Ballroom 3 Concurrent Session I Grand Ballroom 4 Plenary Session 4 Grand Ballroom 1 – 4
10 cancer nursing: leading in a time of change Pullman Albert Park, Melbourne venue floor plan
level 1 ^ ground level >
exhibition floor plan
ENTRANCE EXHIBITION BOOTHS NOT FOR PROFIT DISPLAY TABLES congress meeting rooms
1 2 registration REGISTRATION ENTRANCE
11 exhibition and exhibition opening hours
thursday 24 july saturday 26 july 1700 – 1830 Welcome Reception 1040 – 1120 Morning tea 1320 – 1420 Lunch friday 25 july 1420 Exhibition closes 1020 – 1050 Morning tea 1230 – 1330 Lunch 1510 – 1540 Afternoon tea
exhibitor listing 1 Menzies School of Health Research 26 Aurora Bioscience 2 Cancer Institute NSW 27 Midmed 3 Pierre Fabre Medicament Australia 28 REM Systems 4 Ipsen 29 Roche 5 Cancer Council NSW 30 6 Prostate Cancer Foundation of Australia 31 Celgene 7 & 8 Bristol-Myers Squibb 32 & 33 Hospira 9 Novartis Oncology 34 Amgen Oncology 10 Sirtex Medical Products 35 Cook Medical 11 & 12 B.Braun Australia 36 Bard Access Systems 13 Regional Health Care Group 37 Baxter Healthcare 14 CNSA 38 Cancer Australia 15 Smiths Medical Australasia 39 MSD 16 Mayo Healthcare 40 CareFusion 17 & 18 Fresenius Kabi Australia 41 AngioDynamics 19 M lnlycke Health Care 42 The Australian College of Mental Health Nurses 20 Evomed 43 Boehringer Ingelheim 21 Aspen Australia 44 BD Medical 22 COSA 45 Elekta 23 Ovarian Cancer Australia Table 1 – Breast Cancer Network Australia 24 Table 2 – Look Good…Feel Better 25 Fresenius Medical Care Australia Win an iPad mini Collect your exhibitor stamps in your ‘mini passport’ then hand into the registration desk at lunchtime on Saturday to be in with a chance to win!
12 cancer nursing: leading in a time of change Vascular Access Solutions
Pressure Injectable PICCs
The Right Line The Right P atien t T he R ight Tim e Th e R igh t S ecu rem ent
We have all your education needs covered
ACN’s postgraduate courses are Blood and marrow transplantation; delivered via distance education with Breast cancers; Haematology nursing www.acn.edu.au online components, with ongoing and many more. July intake is now 1800 COLLEGE (265 534) support from experienced course open. (charges may apply) coordinators and subject tutors. Need to improve your clinical skills? [email protected] Nurses working with cancer patients Breast Care Nurse Practicum is a can choose from the following courses five day clinical program developed Caring for your career in July 2014: in collaboration with The Westmead ACN membership benefits can – Graduate Certificate in Cancer Breast Cancer Institute and McGrath help you grow! Nursing Foundation to support registered nurses – Graduate Certificate in Breast in gaining postgraduate and clinical Cancer Nursing knowledge of breast cancer diagnosis and management. Next course starts: Not ready to commit to a full 8 September 2014. postgraduate course? ACN offers over 20 subjects related to cancer nursing: Australian College of Nursing day one // friday 25 July program
THURSDAY, 24 JULY: Pre-Congress Workshop Program 1000 – 1645 Workshop 1: eviQ Education Antineoplastic Drug Administration Course (ADAC) – Facilitation Skills Training (1000 – 1645) Room: Lake 1 & 2 Workshop 2: Optimising Outcomes with Vascular Access Devices in the Cancer Care Setting. (1000 – 1600) Room: Lake 3 & 4 Workshop 3: Delivering Innovative Cancer Survivorship Care (1000 – 1645) Room: Element Workshop 4: COSA Geriatric Oncology Workshop (1000 – 1600) Room: Park 1700 – 1830 Welcome Reception and Networking Opportunity held within the Exhibition Area – Grand Ballroom FRIDAY, 25 JULY: Winter Congress Program, Day One 0700 Registration 0715 – 0815 Breakfast Session 1: The Chris Breakfast Session 2: Optimising O’Brien Lifehouse Implementation supportive care in immuno- Experience Room: Lake oncology: The VOYCE nurses Supported by: network Room: Element
Supported by:
0830 – 0910 Welcome to Country Ceremony Congress Opening Address Professor Jim Bishop AO Welcome Note Sandy McKiernan, CNSA President, and Jac Mathieson, Local Organising Committee Chair 0910 – 1020 PLENARY SESSION 1 Chair: Jac Mathieson Venue: Grand Ballroom 1 – 4 Leading in a time of change: Improving cancer services using experienced based co-design methodology Dr Theresa Wiseman The metamorphosis of melanoma from forgotten disease to poster child Professor Grant A McArthur 1020 – 1050 Morning Tea, Poster Viewing and Exhibition Networking 1050 – 1230 CONCURRENT SESSION A CONCURRENT SESSION B CONCURRENT SESSION C Models of Care (a) Education for Nurses (a) Evidence Based Practice Chair: Nicole Loft Chair: Kylie Ash Chair: Jane Campbell Venue: Grand Ballroom 1 & 2 Venue: Grand Ballroom 3 Venue: Grand Ballroom 4 1050 Epworth Healthcare Leadership An evaluation of registered nurses’ oral A natural oil-based emulsion containing Programs: Developing Nurse Leaders allantoin versus aqueous cream for Esther Yeoman managing radiodermatitis in patients with cancer: a phase III double-blind Polly Dufton randomised controlled trial Raymond Chan 1110 The New Zealand Cancer Nurse ADAC – Standardising skills for all clinical Central Venous Access Device Flushing: Coordinator Initiative: Establishing a new staff Practices and Attitudes Amongst model of nursing care Leisa Brown Australian Cancer Nurses Natalie James Renee McMullen 1130 Finding the key to the lock: Development Leading in a Time of Change – Preparing Acute transfusion reaction knowledge and of the Access Co-ordinator role in a Nurses for the Future of the Deadly Dust management - how well are we doing? cancer imaging department Judy Rafferty Linley Bielby Jac Mathieson 1150 The development of the cancer nurse Intrathecal pain management: Speeding to zero: A nurse led project practitioner role in Australia: A qualitative development of a self-directed learning to reduce central line associated blood study package Ruth McConigley Fleur Holland oncology inpatients Peter Haywood 1210 Measuring What Matters: Quantifying A quasi experimental randomised Randomised controlled trials of an the Activity of Radiotherapy Nurses in a controlled trial utilising a translational energy conservation and management Patient Centred Model of Care research intervention to improve cancer intervention for cancer-related fatigue in Esther Yeoman nurses adherence with recommended men treated for prostate cancer pain screening and assessment practices David Larkin Jane Phillips 1230 – 1330 Breast Special Interest Group Meeting Gynae-Onc Special Interest Group Rad-Onc Special Interest Group Venue: Grand Ballroom 1 & 2 Meeting Venue: Grand Ballroom 3 Meeting Venue: Grand Ballroom 4 1230 – 1330 Lunch 14 cancer nursing: leading in a time of change day one // friday 25 July program
1330 – 1510 CONCURRENT SESSION D CONCURRENT SESSION E CONCURRENT SESSION F Supportive Care (Breast) Education for Nurses (b) Survivorship Chair: Elisabeth Black Chair: Margaret Rankin Chair: Maryanne Hargraves Venue: Grand Ballroom 1 & 2 Venue: Grand Ballroom 3 Venue: Grand Ballroom 4 1330 Men get breast cancer too: An information Eliciting Key Clinical Information – What Nurse-led survivorship clinic in practice resource for men with breast cancer to ask and why in Radiotherapy Kerry Shanahan Annie Gayed Margaret Hjorth 1350 A Melbourne based nursing perspective eviQ Education - Supporting best practice Women’s experience of Breast Care on Advanced Breast Cancer (ABC) through patient focused evidenced based Nurses in a Survivorship Clinic supportive care: Is ABC as easy as 1, 2, radiation oncology modules Lee Kennedy 3? Kim Faulkner Melanie Fisher 1410 The role of the Australian Breast Care The effect of language on cancer nursing Helping Indigenous people with cancer to Nurse: a self-report online survey practice better navigate towards optimal care: a Tracey Ahern Olayinka Akinsanmi pilot study Christina Bernardes 1430 Enhanced Surveillance of Gestational eviQ Bridging the gap – real-time Developing a Rehabilitation Framework Breast Cancer evidence retrieval using a bibliometrics For Cancer Survivorship Nasrin Javid solution Trish Calder Catherine Johnson 1450 Queensland’s Extension of EdCaN to Breaking down the Barriers: Examination partner through breast cancer: An Queensland-Cancer Education Program of the Barriers to Psychological Screening information resource for partners of (Q-CEP) and Referral of Men with Chronic Illness women with breast cancer Leisa Brown Displaying Signs of Distress Annie Gayed Georgina Wiley 1510 – 1540 Afternoon Tea 1540 – 1650 PLENARY SESSION 2 Chair: Donna Milne Venue: Grand Ballroom 1 – 4 Dressing and securement options for central venous access devices: Do they work, or are they just more work?! Professor Claire Rickard Facing an uncertain future: Cancer care in the era of antimicrobial resistance Associate Professor Karin Thursky 1930 – 2300 Congress Gala Dinner – Pullman Albert Park Venue: Grand Ballroom 1 & 2
15 day two // saturday 26 July program
: Winter Congress Program, Day Two 0800 Registration 0715 – 0815 Education Committee Meeting Room: M10 0830 – 0940 Plenary Session 3 Chair: Sandy McKiernan Venue: Grand Ballroom 1 – 4 Improving the patient journey through better mental health care: Core business for all nurses Adjunct Associate Professor Kim Ryan Cancer Care in Indigenous communities, with advances in personalised medicine are we closing the gap in health outcomes? Associate Professor Gail Garvey 0940 – 1040 CNSA AGM Venue: Grand Ballroom 1 – 4 1040 – 1120 Morning Tea, Poster Viewing and Exhibition Networking 1120 – 1320 CONCURRENT SESSION G CONCURRENT SESSION H CONCURRENT SESSION I Models of Education for Patients Supportive Care Care (b) Chair: Keith Cox Chair: Tish Lancaster Chair: Trevor Saunders Venue: Grand Ballroom 1 & 2 Venue: Grand Ballroom 3 Venue: Grand Ballroom 4 1120 Resilience Support Group Model: A The role of team leader in promoting Western Health Oncology Hospital in the tailored information and peer support supportive care screening among cancer Home: issues for patients, caregivers and program for women newly diagnosed with nurses. ovarian cancer and their carers Catherine Johnston cancer treatment Tarnya Hotchkin Andy Robinson 1140 Cancer Council Helpline – how many Distress Screening and Supportive Care Innovative Nursing Workforce Strategy.... people use this information and support Needs of Cancer Patients and Carers in Incorporating an Endorsed Enrolled Nurse service and why not? Regional Western Australia into a Chemotherapy Day Unit Monica Byrnes Allison Fosbery Karen Munton 1200 Using web-enabled technology to support Digital information service and Cancer Improving Cancer Symptom and men with prostate cancer Supportive Care: A Victorian Perspective Chemotherapy Toxicity Management for David Blashki Chan Cheah Patients undergoing Chemotherapy at Western Health Angela Mellerick 1220 The development and evaluation of Same same but different: comparison Expanding the scope of practice of the resources for friends of young people of oncology nurses family practices in Enrolled Nurse to include administration living with cancer Australia and Denmark of antineoplastic agents: Key issues and Elizabeth Kelly-Dalgety Elisabeth Coyne recommendations of the CNSA Education Committee Kylie Ash 1240 A shift in paradigm – Central Integrated The implications of the withdrawal of the “Let’s talk about Sex ” – The Regional Cancer Service (CIRCS) Cancer Liverpool care pathway in the UK for implementation of a Nurse Practitioner Education Program Australia: A discussion paper (NP) led Sexual Health and Erectile Leisa Brown Raymond Chan Dysfunction (SHED) clinic at Peter MacCallum Cancer Centre (Peter Mac) Kath Schubach 1300 Evaluation of the gynaecology basic How do prostate cancer specialist nurses’ sexual health assessment questions professional development needs change included in the supportive needs over time? screening tool Julie Sykes Taryn Robinson 1320 – 1420 Lunch Venue: M10 1420 – 1440 Awards Presentations 1440 – 1550 PLENARY SESSION 4 Chair: Raymond Chan Venue: Grand Ballroom 1 – 4 Developing community pathways for people living with and beyond cancer Dr Theresa Wiseman Panel Discussion – New and Innovative Models of Care of care to continue to provide best practice care to our patients? Dr Theresa Wiseman, Associate Professor Gail Garvey and Adjunct Associate Professor Kim Ryan discuss their thoughts. This session will be facilitated by Dr Raymond Chan. 1550 – 1600 Welcome to Congress 2015 Ruth McConigley, WA LOC Chair Closing Address CNSA President, Sandy McKiernan
16 cancer nursing: leading in a time of change name badge pocket. Please hand this in to the registration desk no later than lunch time poster listing on Saturday.
poster poster title presenter no.
1 A severe Docetaxel skin reaction: A case report Gillian Blanchard
2 Co-ordination of supportive care needs in metastatic breast cancer Melissa Warren
3 Promoting awareness in quality radiotherapy nursing Kathryn Watty
4 My journey as a novice researcher: A journey worth taking! Rachel Pitt
Peripherally inserted central catheter (PICC) cushioning material: A pilot 5 Kerrie Curtis study comparing gauze with silicone foam for chemotherapy patients
Crowning glory – is that the whole story? Implementing scalp cooling in an 6 Kerrie Andrews Australian setting
7 Psychosocial nursing interventions for patients with cancer Giselle Ciavarella
8 Who are today’s leaders? Karen O’Dell
9 PICCs, ports and peripheral cannulas – the patients’ perspective Alison Szwajcer
10
Extending the scope of practice of an endorsed enrolled nurse in a 11 chemotherapy day unit.... What can they do?
12 Dabrafenib, a new era – targeted therapies and side-effects Theresa Nielsen
13 Online patient-held resources for improving cancer pain management
14 Nurse care guides – a communication, education and documentation tool Linda McGinn
The establishment of Chemo@home – an integrated model of patient 15 Lorna Rogers centred service delivery for chemotherapy patients
Development and implementation of Australian consensus guidelines for 16 the safe handling and administration of monoclonal antibodies for cancer Trevor Saunders treatment by healthcare personnel Urgent care of the oncology patient – analysis from a cross sectional 17 study of the clinical characteristics of oncology patients presenting to one Meredith Oatley Sydney tertiary referral emergency department
Professional challenges and support mechanisms for breast care nurses 18 Pammie Ellem in rural and remote Queensland
A tablet a day? Introducing a mobile electronic device into home based 19 Robyn Wilson cancer care
20 Ipilimumab: The importance of nursing education and patient Theresa Nielsen
17 17th winter congress abstracts friday 25 july
breakfast session 1 treatment. Attendees will have the opportunity to participate in case study discussion and make new connections for the soon The Chris O’Brien Lifehouse Implementation to be launched Nurse VOYCE! Experience References Supported by: 1. Bristol-Myers Squibb. YERVOY Approved Product Information, 31
Presenter: Kate Baychek plenary session 1 LEADING IN A TIME OF CHANGE: IMPROVING Description CANCER SERVICES USING EXPERIENCED Kate Baychek is a Clinical Nurse Educator in Day Therapy at BASED CO-DESIGN METHODOLOGY the Chris O’Brien Lifehouse centre in Sydney NSW. Lifehouse Dr Theresa Wiseman is a new purpose-built, comprehensive cancer care centre, The Royal Marsden NHS Foundation Trust, London, UK 2013. The vision of Lifehouse is to provide uncompromising Background and aims care to patients, housing all of the cancer services under one This project sought to design better experiences for patients and health care staff from the breast and lung cancer Radiation Oncology and Medical Imaging departments. The services within two large teaching hospitals in England. second phase to be opened by the end of 2014 will include Experience based co-design (EBCD) was the chosen action theatres, wards and an Intensive Care Unit. In the pledge to research approach (Bate and Robert 2007). EBCD is a new provide uncompromising care to patients, the care of staff is and innovative methodology combining (1) a user-centred a high priority as is the utilisation of evidence-based practice. orientation (by adopting a narrative storytelling approach) and In choosing the equipment for use in the Day Therapy Centre, (2) a participatory, collaborative change process, allowing staff implementing a closed system was a priority for the protection to ‘see the person in the patient’ and placing patient and staff of staff and to comply with the NSW WorkCover guidelines. The experience at the centre of service development. Nurse Unit Manager chose the Hospira CLAVE™ Oncology Methods and results needlefree closed system for the nursing staff to use in the The project explored how care was delivered by staff and delivery of antineoplastic agents. Kate Baychek will share with you the Lifehouse experience of implementing the Hospira 60 staff interviews, and ethnographic observation of clinical CLAVE Oncology closed system. areas. Patient and staff interviews were analysed to identify themes and issues which were fedback to patients and staff at various group events. Through a facilitated three-stage change breakfast session 2 process which will be described, patients and staff agreed on Optimising supportive care in immuno- joint priorities for improvement and then worked together in oncology: The VOYCE nurses network example information provision, day surgery, continuity of care, Supported by: diagnosis and outpatient care). Discussion and conclusions Presenters: Donna Milne, RN PhD experiences through the use of EBCD. It explores the value of Lydia Visintin, RN the EBCD approach, the use of narratives, observation and Description care and engaging staff and patients in a change process YERVOY® (ipilimumab) is an immuno-oncology agent that to facilitate meaningful and lasting improvements in service 1,2 . It provision. some patients with advanced melanoma; however, treatment References can be associated with immune-related adverse reactions Bate, P and Robert G. (2007). Bringing User Experience to HealthCare Improvement: the concepts, methods and practices of experience (irARs).1,2 Cancer nurses play an important supporting role based design. Radcliffe, Oxford. in managing patients treated with YERVOY (ipilimumab). Nurse VOYCE (yerVOY Clinical nEtwork) is designed to aid & Wiseman T (2012) Implementing patient-centred cancer care: cancer nurses in supporting patients on YERVOY. The Nurse using experience-based co-design to improve patient experience in VOYCE breakfast meeting will feature a panel discussion and breast and lung cancer services, Supportive Care in Cancer, 2012 case studies from nurses who have extensive experience in managing patients with advanced melanoma on YERVOY
18 cancer nursing: leading in a time of change abstracts friday 25 july
THE METAMORPHOSIS OF MELANOMA FROM Leadership Program to staff working in both clinical and non FORGOTTEN DISEASE TO POSTER CHILD that Epworth has committed to the development of its leaders Professor Grant A McArthur and this investment is unparalleled in the healthcare industry. Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, VIC, Australia Objectives/Aims To develop leadership competencies that will contribute to the Sustained investment in the science of cancer has uncovered success of employees in leadership roles through a structured key molecules that control the growth of melanoma and the leadership program. bodies immune response to the disease. This investment has now transformed the disease clinically with novel systemic Description/Methodology therapies currently leading a paradigm shift in how melanoma Delivered over a 12 month period, the program is aligned patients are managed. The greatest transformation is in the with Swinburne University’s Diploma of Management. The area of immune therapies, where very sustained responses are suggesting “clinical cure” is in sight for some patients with advanced disease. The new immune therapies raise project over the program period. Content of the program was challenges in the management of toxicity and need for well- organised survivorship programs. The immune therapies behaviours and knowledge, of high performing leaders within the organisation. Results of these agents is striking. The CTLA4-inhibitory antibody Evaluation surveys are undertaken three months after ipilimumab can improve overall survival in patients with completion of the program involving participants, their managers advanced disease leading to 20% of patients obtaining long- positive behavioural change in participants and overwhelming the programmed death-1 receptor (PD-1) or its ligand PD- acceptance of the program across the organisation. L1 that generate responses in an even higher proportion of patients. The melanoma genome is now well described with Conclusions over 60% of patients having genomic events that activate the A structured approach to leadership development has been BRAF pathway. This has led to systemic therapies that improve an effective way of enhancing the leadership capabilities of overall survival in the advanced disease setting, and new emerging and operational nurse leaders. combination treatments with response rates of almost 90% moving us into a precision medicine approach for melanoma THE NEW ZEALAND CANCER NURSE patients with BRAF mutations. Perhaps the greatest promise COORDINATOR INITIATIVE: ESTABLISHING A to impact mortality from melanoma, a disease characterized by NEW MODEL OF NURSING CARE the development of metastases from small primary tumours, 1 2 is the combination of systemic therapies in patients with low Natalie James , Saskia Booiman volumes of disease, such as in the adjuvant setting. The 1. National Nurse Lead - cancer nurse coordinator initiative, future is bright for patients with this challenging disease where Ministry of Health, Auckland, New Zealand multidisciplinary care is poised to substantially reduce mortality 2. Cancer Services, Ministry of Health, Wellington, New and vastly improve quality of life. Zealand Introduction In 2012 funding was approved to appoint 40 cancer nurses concurrent session a: across NZ who would focus on coordinating patient care along the cancer pathway; with at least one cancer nurse coordinator models of care (a) (CNC) in each District Health Board (DHB). Consultation with Australian nurse-leaders raised concern that these roles might EPWORTH HEALTHCARE LEADERSHIP not be well supported because the 20 DHB’s in NZ could result PROGRAMS: DEVELOPING NURSE LEADERS in different versions of the roles. It was proposed that a National Esther J Yeoman1, Margaret Hjorth1 Nurse Lead (NNL) be appointed to provide professional leadership and to ensure a strategic and consistent approach 1. Epworth HealthCare, Richmond, VIC, Australia Objectives/Aims Introduction To develop a national CNC service that improves the timeliness Nurse leaders can positively impact the standard of clinical and quality of care for NZ’ers with cancer. care and workplace culture within an organisation. For this to be realised, it is critical that nurses have the necessary Description/Methodology skills and experience. Historically, leadership training has The NNL worked with the CNC’s to establish regional groups not formed part of nursing education. Epworth Healthcare that support networking and communication. These groups have been instrumental in ensuring the nurses remain focused its nursing workforce. Since 2009, Epworth has delivered its on the common purpose and outcome of the roles, even
19 17th winter congress abstracts friday 25 july
Conclusion provide a consistent forum to share information about care and Overall the introduction of CID Access Co-ordinator has service improvements. Further underpinning this approach to established timely and appropriate access for patients, care has been the development and implementation of tools promoting optimal patient care in the CID. and resources that support the establishment of the role and the day to day work of CNC’s. THE DEVELOPMENT OF THE CANCER NURSE Results PRACTITIONER ROLE IN AUSTRALIA: A The CNC’s and DHB’s have responded well to national QUALITATIVE STUDY leadership. Nurses routinely attend service development and Ruth McConigley1, Keith Cox2, Samantha Gibson3 education meetings. The implementation and evaluation of 1. Curtin University, Bentley, WA, Australia 3. St John of God Hospital, Subiaco, WA, Australia Conclusions Introduction The establishment of a NNL has been important factor in Nurse Practitioners (NPs) were introduced in Australia in the progressing this initiative. 1990s, primarily as an innovative way of providing health care in rural and remote areas. NPs are now found in many practice FINDING THE KEY TO THE LOCK: settings and the role has evolved to be more of a specialist DEVELOPMENT OF THE ACCESS CO- nurse position. Little is known about the development of the ORDINATOR ROLE IN A CANCER IMAGING nurse practitioner role in cancer settings in Australia. DEPARTMENT Aims/Objectives Jac Mathieson1, Donna Milne1 The aim of this project was to examine the current role of 1. Peter MacCallum Cancer Centre, East Melbourne, VIC, cancer nurse practitioners (CNPs) and nurse practitioner Australia candidates and to explore ways of developing the role further. Background The diagnosis of cancer and decisions about optimal management are reliant on timely access to a Cancer Imaging Department (CID). The CID at Peter MacCallum Cancer Centre completes an average of 31,000 scans (CT, PET, US, MRI) and interventions per year but until recently did not have an established triage process resulting in lengthy delays for CNP role. clinicians and patients. Methodology Aim A descriptive, exploratory qualitative design was used for this To establish timely and appropriate access for patients, reduce study. Focus groups and individual interviews were held with 8 CNPs and a comprehensive survey describing their clinical within the department. practice was completed by 25 CNPs and candidates. Methodology Results A CID Access Co-ordinator role was developed and became The results of this study show that CNPs have varied roles the central point of access for referring clinicians. This role was are similarities in some areas of practice, including having and outpatient bookings that were not able to be booked in the leadership, teaching and mentoring roles and promoting required time frame were triaged by the Access Co-ordinator. clinical excellence. Issues faced by CNPs include accessing Essential clinical information was gathered and discussed with funding and continued stability of CNP positions. the triaging radiologist, radiographers working in the modalities as well as the referring clinicians to ensure an appropriate time Conclusions was allocated. The CNP has a wide scope and each position varies in what is expected. However, similarities suggest that it would be Results prudent for CNPs to work together to promote and develop The wait time for imaging decreased from six weeks to same this role. Interrupting phone calls to the radiographers (staff performing the scan) have decreased from approximately 25 per day to zero and there has also been a reduction in the interruptions to the reporting radiologist (staff reporting the scans). Clinician triaging process, timeliness of imaging and access to results.
20 cancer nursing: leading in a time of change abstracts friday 25 july
MEASURING WHAT MATTERS: QUANTIFYING concurrent session b: THE ACTIVITY OF RADIOTHERAPY NURSES IN A PATIENT CENTRED MODEL OF CARE education for nurses (a) Esther J Yeoman1, Margaret Hjorth1 AN EVALUATION OF REGISTERED NURSES’ 1. Epworth HealthCare, Richmond, VIC, Australia ORAL CRYOTHERAPY KNOWLEDGE AND Introduction CONFIDENCE IN THE ACUTE HAEMATOLOGY/ Nurses play an essential role in improving the experience of ONCOLOGY SETTING: A PRE-TEST/POST- patients undergoing radiotherapy treatment. However, the TEST PILOT STUDY 1 1 differences across departments in relation to model of care, Polly Dufton , Liz Pascoe clinical responsibilities, EFT requirements, education and 1. School of Nursing & Midwifery, La Trobe University, training. This has direct implications on resource planning, Bundoora, VIC, Australia credentialing, and furthering radiotherapy nursing as a Introduction Oral cryotherapy is an established intervention for preventing challenge of understanding the role of the radiotherapy nurse chemotherapy induced oral mucositis (Keefe et al., 2007). by utilising information technology to track and quantify nurse Nurses have a primary role in the initiation of oral cryotherapy. activity. Objectives/Aims nurses with the aim of increasing their knowledge and To obtain a clearer understanding of the role of the radiotherapy nurse through analysis of activity tracking, based on our Objectives/Aims experience in a busy radiotherapy department at Victoria’s best-practice evidence and its administration before and after Description/Methodology an educational intervention. Our paperless department utilises an oncology patient Description/Methodology management system, Varian Medical System’s ARIA. All activity based care is captured by data entry as episodes of setting participated in a 20-minute oral cryotherapy education care are delivered. The system will be used to closely track the session. Supporting visual educational materials comprising clinical activity of radiation oncology nurses over a set period posters and laminated personal tags as prompts to practice, of time. Activity reports will be generated to facilitate analysis and self-adhesive labels for recording the administration of data. of oral cryotherapy were provided to nurse participants. All Results participants completed a questionnaire before and immediately The data obtained from tracking clinical activity of radiotherapy after the education intervention. Twenty-two nurses (70%) nurses over a six week period will be presented. provided feedback approximately 4 weeks post intervention on the supporting visual materials as prompts to practice. Conclusions Understanding the breadth and depth of clinical roles is a vital Results component of workforce management. Utilisation of computer information systems to track activity may be an effective strategy towards understanding the role of the radiotherapy its administration were reported post intervention. Statistical nurse working with a patient centred model of care. package: SPSS Version 20 for Windows (SPSS Inc. IL USA). Conclusions A short education session on oral cryotherapy accompanied by supportive visual materials may be an effective way to increase cryotherapy.
21 17th winter congress abstracts friday 25 july
ADAC – STANDARDISING SKILLS FOR ALL Objectives/Aims CLINICAL STAFF To meet the needs of the increasing number of patients diagnosed with an asbestos-related disease (ARD) Leisa M Brown1, Maree A Bransdon1 1. CIRCS, QLD Health, Bowen Hills, QLD, Australia Lung Foundation Australia developed and piloted a Clinical Introduction Education Program for nurses. The objective of the program Queensland undertook to standardise the skills required to was to develop knowledge and specialised skills to enable nurses to provide quality care and more timely intervention for implementing ADAC. Queensland determined that ADAC was relevant to all clinical staff who may be involved with Description/Methodology cytotoxic waste management or administration of oral cytotoxic Ten nurses from around Australia were selected to pilot medications for malignant and non-malignant disease. To achieve course requirements and address geographical developed, an advisory committee of health professionals disparity, Telehealth was engaged to enable clinical practice established, online developers engaged, and nurses’ and competency completion. knowledge (including pre and post program questionnaire, Objectives/Aims post module quizzes, post program exam and case history, To provide all clinical staff with the skills to meet the National six clinical practice components) and program processes were Safety and Quality Health Service Standards (2012) for evaluated. Evaluation data demonstrated increased knowledge Medication Safety: 4.11 and High Risk Medicines – Medication and positive appraisal of the program from the ten nurses. Safety Self Assessment (2012): 10.38 by using a blend of face- Results to-face and Telehealth to deliver ADAC. Description/Methodology provide leadership and mentorship in conjunction with existing Specialist Lung Cancer Nurses throughout Australia to improve Queensland’s needs. A model was developed to demonstrate outcomes for this unique group of patients. the complexity of this process and the importance of networking Conclusions and communication using a ‘top down’ ‘bottom up’ approach. Telehealth was made available to ensure timely access to is an effective strategy to develop nurses’ knowledge and skills to enable them to meet the unique needs of this growing and rostering options due to small staff numbers. population. Results References There are currently over 400 participants enrolled in ADAC 1. National Strategic Plan for Asbestos Awareness and Management with the use of Telehealth for clinical practice demonstrations, competency assessment and delivery of the ADAC Train the Trainer and skills workshop. Conclusions 2010; 40:742–50 ADAC has enabled the standardisation of safe handling, oral and IV cytotoxic medication administration. The innovative delivery of ADAC in Queensland helps to provide a supply INTRATHECAL PAIN MANAGEMENT: of skilled health professionals to manage safe handling and DEVELOPMENT OF A SELF-DIRECTED administration of cytotoxic medications. LEARNING PACKAGE Fleur Holland1, Catherine Debono, Hazel Kompara LEADING IN A TIME OF CHANGE – 1. SJOG Hospital Subiaco, Perth, WA, Australia PREPARING NURSES FOR THE FUTURE OF Introduction THE DEADLY DUST Cancer nurses play a crucial role in assessing and managing Judy Rafferty1, Glenda Colburn1, Nigel McPaul1 patients with complex pain. Nursing care for patients requiring 1. Lung Foundation Australia, Brisbane, QLD, Australia pain management through the use of intrathecal analgesia requires nurses to have expert knowledge and skills in Introduction managing this specialised route of analgesia administration. Australia has the highest incidence of Mesothelioma per capita Exposure and experience for nurses managing these devices in the world (1). The recent epidemic of mesothelioma is closely is limited. A self-directed learning package (SDLP) was associated with past occupational exposure to asbestos. considered a sound educational tool that was easily accessible There is increasing evidence that a third; non-occupational to all nurses working within the cancer centre. wave of mesothelioma cases has developed in Australia, with a projected increase of 79% by 2020 (2). Objectives To improve nursing knowledge and skill development in the management of patients receiving intrathecal analgesia.
22 cancer nursing: leading in a time of change abstracts friday 25 july
Description Methods: Survey and chart audit data collected: pre (T1) and post audit and feedback. managing patients receiving intrathecal analgesia. Clinical and Intervention: 11 case based pain assessment scenarios delivered to participants’ emails over 28 days via the ‘Qstream© included in the development of a SDLP pertaining to intrathecal methodology; plus audit and feedback of pain assessment pain management. The package included aetiology of cancer documentation (T1-T2 data). pain, effects of uncontrolled pain, spinal anatomy, intrathecal Results complications and troubleshooting. The package required Nurses who completed the on-line learning module (n=51) each registered nurse to successfully complete 24 questions in addition to a procedural competency assessment. Results increasing linear trend in documented pain assessments in patients chart from T1-T2 and T4 and an increased median demonstrating a greater understanding and competence in quality of pain assessment documentation scores across time. management of intractable pain through the use of intrathecal analgesia drug delivery. Conclusions Integrating specialised on-line clinical content and audit Conclusion feedback improves nurses’ pain assessment practices, which Through the development and implementation of a SDLP on knowledge to safely and effectively care for patients receiving Disclosure: This project was supported by a Cancer Institute NSW grant. intrathecal pain relief.
A QUASI EXPERIMENTAL RANDOMISED CONTROLLED TRIAL UTILISING A concurrent session c: TRANSLATIONAL RESEARCH INTERVENTION evidence based practice TO IMPROVE CANCER NURSES ADHERENCE WITH RECOMMENDED PAIN SCREENING AND A NATURAL OIL-BASED EMULSION ASSESSMENT PRACTICES CONTAINING ALLANTOIN VERSUS AQUEOUS Jane L Phillips1, Nicole Heneka2, Louise Hickman3, CREAM FOR MANAGING RADIODERMATITIS Jane Ingham2, Lawrence Lam4 5, Tim Shaw5 IN PATIENTS WITH CANCER: A PHASE III 1. Cunningham Center for Palliative Care & University of DOUBLE-BLIND RANDOMISED CONTROLLED Notre Dame Australia, Darlinghurst, NSW, Australia TRIAL 2. The Cunningham Centre for Palliative Care, Darlinghurst, Raymond J Chan1 2 3, Jacqui Keller3, Lee Triponcy3, NSW, Australia Robyn Cheuk3, Rae Blades3, Sam Keogh4, Jennifer 3. University of Technology, Sydney, NSW, Australia Mann3 4. Hong Kong Institute of Education, Hong Kong, SAR, China 1. School of Nursing, Queensland University of Technology, 5. Sydney University, Sydney, NSW, Australia Kelvin Grove, QLD, Australia Introduction 2. Institute of Health and Biomedical Innovation, Queensland Unrelieved cancer pain continues to be a major public health University of Technology, Kelvin Grove, QLD, Australia concern with timely access to best-practice, evidence-based assessment and care integral to improving cancer pain Hospital, Herston, QLD, Australia management. This project utilised a tailored, online learning module to translate the evidence that exists for comprehensive pain assessment, management and regular re-assessment of Introduction pain into routine nursing practice. Radiodermatitis is a distressing symptom frequently Objectives/Aims experienced by patients undergoing radiotherapy. To test the impact of a tailored case-based pain assessment on- Aims line learning module (Qstream©) and pain assessment audit To investigate the effects of a natural oil-based emulsion and feedback, on inpatient cancer nurses pain assessment containing allantoin (NOCA) versus aqueous cream (AC) on capabilities and practices. reducing radiodermatitis in patients with breast, lung and head Description/Methodology and neck cancer receiving radical radiotherapy. Study design: Pre-post-test prospective follow-up study with a quasi-experimental wait-listed randomised controlled trial (RCT) at one site.
23 17th winter congress abstracts friday 25 july
Methodology Results A total of 174 patients were randomised to either receive NOCA or AC. Participant and clinical characteristics, Common Terminology Criteria for Adverse Events skin toxicity, pain, towards evidence regarding CVAD management practices, itching and skin-related quality of life (SRQoL) scores were and the extent of training regarding CVADs were the key collected weekly up to 4 weeks after radiation treatment completion. Conclusions Results Consistent with Carper’s (1978) four patterns of knowledge, this from different sources, when making clinical decisions higher average levels of skin toxicity at weeks 7, 8 and 9 (all to the NOCA group at week 3, but not at other weeks. There were no major differences in SRQoL between groups. Results ACUTE TRANSFUSION REACTION of the multivariate regression model indicate that there was a KNOWLEDGE AND MANAGEMENT – HOW strong trend for AC to reduce the incidence of grade 2 or more WELL ARE WE DOING? skin toxicity in comparison to NOCA (p=0.056). Jo Perillo1, Bridget Glazebrook1, Lisa Stevenson1, Conclusions Peter Beard1, Linley Bielby1 Although the NOCA appeared to be more effective for managing 1. Blood Matters, West Melbourne, VIC, Australia skin toxicity compared to AC at the early stage of treatment Introduction The Australian Commission on Safety and Quality in Healthcare appears to be a more preferred option. Health Service Standard 7 has increased the emphasis to assess risks associated with transfusion practices. In 2013, Blood Matters audited ‘Acute transfusion reaction (ATR) CENTRAL VENOUS ACCESS DEVICE knowledge and management’. FLUSHING: PRACTICES AND ATTITUDES AMONGST AUSTRALIAN CANCER NURSES Objectives/Aims The aim was to determine if transfusion policies included the Renee McMullen1 2, Patsy Yates3 1. Icon Cancer Care, Brisbane, QLD, Australia on national guidelines, understood and practised. 2. Master of Nursing Student, QUT, Brisbane, QLD, Australia 3. Professor, QUT, Brisbane, QLD, Australia Description/Methodology Four state and territory health services (n=146) were invited. Introduction Three electronic audit forms to assess policy, management Central Venous Access Devices (CVADs) are utilised by (up to 10 retrospective ATRs within 12-months) and survey of Australian cancer nurses in the delivery of patient treatment clinical staff about ATR recognition and management (up to such as chemotherapy. Flushing is undertaken to maintain 30). patency and prevent occlusion of CVADs, however there are Results One hundred hospitals submitted at least one part of the Objectives/Aims audit, with all reporting a written policy including guidelines for management of an ATR. cancer nurses. Secondly, to identify knowledge, attitudinal and largest clinical specialty at 35% (n=101). Febrile and allergic Description/Methodology This project is underpinned by Carper’s (1978) four fundamental patterns of knowledge. This study utilised a after commencement, reinforcing why strict monitoring of the descriptive survey design and was conducted in two phases. patient is required. In phase one a preliminary survey instrument was developed based on the major themes in the literature. The preliminary The staff survey demonstrated good knowledge of recognising survey instrument was pre-tested by a group of six content experts. In phase two an invitation to participate in the online “stop the transfusion” (97%). Actual practice audited reported self administered survey was emailed to 840 CNSA members. Responses of 182 Australian cancer nurses were avaiable for data analysis.
24 cancer nursing: leading in a time of change abstracts friday 25 july
Conclusion RANDOMISED CONTROLLED TRIALS OF AN ENERGY CONSERVATION AND MANAGEMENT who demonstrated they understood and practiced ATR INTERVENTION FOR CANCER-RELATED management well. Health services were also keen to utilise FATIGUE IN MEN TREATED FOR PROSTATE answers to the survey as a follow up education tool. CANCER David Larkin1 2, Violeta Lopez3, Edoardo Aromataris2 SPEEDING TO ZERO: A NURSE LED 1. CACHS, ACT Health, Garran, ACT, Australia PROJECT TO REDUCE CENTRAL LINE 2. Health Sciences, University of Adelaide, Adelaide, SA, ASSOCIATED BLOOD STREAM INFECTIONS Australia IN HAEMATOLOGY/ONCOLOGY INPATIENTS 3. National University Singapore, Singapore Peter Haywood1, Elyse Harley1 Introduction 1. Royal Melbourne Hospital, North Melbourne, VIC, Australia Cancer and its treatment result in a number of side effects. Introduction Cancer-related fatigue (CRF) is one of the more debilitating Central line associated blood stream infections (CLABSI) are side effects, and often is not assessed or well managed. For a preventable cause of morbidity and mortality in patients men treated for prostate cancer, only a few interventions have with cancer. Standard guidelines aimed at avoiding CLABSI are available, but not widely implemented. We undertook a Objectives/Aims nurse-led project to monitor CLABSI incidence in our unit and To assess the effectiveness of an energy conservation and then systematically introduced guideline compliant practice to management intervention for reducing the impact of CRF on reduce the CLABSI rate. men who are commencing treatment or who have completed Objectives/Aims treatment within the previous twelve months. Methods implement existing guidelines and monitor impact. 30 men commencing treatment and 31 men who had Description/Methodology completed treatment for prostate cancer were randomised to We undertook a monthly review of all blood culture results on either intervention or control groups. Participants completed a demographics form and three questionnaires: Schwartz Ward management practices including chlorhexidine at line Performance Inventory. The intervention group received three weekly telephone calls providing targeted education about were then systematically altered to comply with NHSN CRF in relation to prostate cancer, strategies for balancing guidelines. energy expenditure and rest, sleep hygiene and dietary advice. The control group received the same number of Results phone calls providing dietary and nutrition advice. The three questionnaires were repeated at one month and two months from 1668 line days to give a rate of 9.0 per 1,000 line days. following the provision of education. Results 1787 line days (2.2 per 1,000 line days, p=0.001), with a improvements in fatigue, vigor and functional performance the initial establishment period we required an extra six hours compared to control groups following the delivery of the energy per month of extra nursing time. Now, no extra nursing time is conservation and management intervention. required. Conclusion Conclusions An energy conservation and management intervention that In this nurse led project requiring minimal nursing resources, incorporates targeted information relevant to prostate cancer we were able to implement changes in central line nursing may be an effective strategy for managing CRF in men treated for this cancer.
25 17th winter congress abstracts friday 25 july
concurrent session d: A MELBOURNE BASED NURSING PERSPECTIVE ON ADVANCED BREAST supportive care (breast) CANCER (ABC) SUPPORTIVE CARE: IS ABC AS EASY AS 1, 2, 3? MEN GET BREAST CANCER TOO: AN Melanie Fisher1, Bronwyn Flanagan2, Sally INFORMATION RESOURCE FOR MEN WITH Greenberg1, Kathy Hendry1, Kerry Shanahan2, BREAST CANCER Leanne Storer1 Annie Gayed1, Kathy Wells1, Maxine Morand1 1. Western Health, Footscray, VIC, Australia 1. Breast Cancer Network Australia (BCNA), Camberwell, 2. Royal Melbourne Hospital, Melbourne, VIC, Australia VIC, Australia Introduction Introduction Due to advancements in management women diagnosed The vast majority of Australians diagnosed with breast cancer are women, however around 125 men in Australia are diagnosed each year. BCNA sometimes hears from men best practice has been recognised locally by North Eastern diagnosed with breast cancer about a lack of information that Integrated Cancer Services (NEMICS) and internationally with The 1st International Consensus Guidelines for Advanced isolated and distressed. A web-based review found very little Breast Cancer A gap in service provision for Advanced Breast Cancer (ABC) Objectives/Aims BCNA aimed to develop an information resource for men to Melbourne Health (MH) and the Royal Women’s Hospital address this unmet need. (RWH). Description/Methodology Objectives/Aims An informal working group was established to guide To develop and implement a pathway for ABC patients, development of the resource. The group included eight men resulting in timely MDM discussion, supportive care screening diagnosed with breast cancer, family members, and health professionals including medical oncologists, surgeons and and primary care providers. psycho-oncology practitioners. Description/Methodology Results Initially a retrospective (pre pilot) audit of all ABC diagnosed patients at participating sites was undertaken, and information newly diagnosed with breast cancer. Men get breast cancer too about diagnosis, coordination of care, supportive care and provides tailored information about the types of breast cancer, MDM discussion analysed. These patients and their GP’s breast cancer treatments, follow-up care, lymphoedema, secondary breast cancer and ways to deal with common the development of a best practice Model of Care (MOC) which challenges that men may face, such as coping with their was piloted for a three month period. diagnosis and concern about the cancer coming back. The Following this period, another audit was conducted, with the booklet also lists other resources and emotional and practical same methodology as previous, on ABC patients diagnosed support services available for men diagnosed with breast within the pilot period. cancer. Conclusions Results Increased number of patients with ABC were discussed at diagnosed with breast cancer which the new booklet provides. RWH 52% improvement). BCNA needs the vital support of health professionals, including cancer nurses, to help us reach men with this resource. There were increased number of patients with ABC who underwent supportive care screening, assessment and improvement). Conclusions We have demonstrated that implementing a best practice pathway for ABC patients is a simple and effective process to ensure optimal and coordinated medical and psychosocial ongoing care.
26 cancer nursing: leading in a time of change abstracts friday 25 july
THE ROLE OF THE AUSTRALIAN BREAST ENHANCED SURVEILLANCE OF CARE NURSE: A SELF-REPORT ONLINE GESTATIONAL BREAST CANCER SURVEY Nasrin Javid1, Christobel Saunders2, Fran Boyle3, Tracey Ahern1, Anne Gardner1, Mary Courtney2 Angela Ives2, Jan Dickinson2, Elizabeth Sullivan1, 1. School of Nursing, Midwifery and Paramedicine, Australian on behalf of AMOSS investigators Catholic University, Dickson, ACT, Australia 1. University of New South Wales, Sydney, NSW, Australia 2. School of Nursing, Midwifery and Paramedicine, Australian 2. University of Western Australia, Perth, WA, Australia Catholic University, Brisbane, QLD, Australia 3. University of Sydney, Sydney, NSW, Australia Introduction Introduction Since the establishment of the breast care nurse (BCN) role Gestational breast cancer (GBC) refers to the initial diagnosis in Australia in the mid-1990s, their role in different practice of breast cancer during pregnancy or within 12 months of contexts and geographical locations has yet to be reported. To delivery. GBC has a low incidence rate of approximately 23-29 address this gap, a self-report online survey exploring current BCN roles in different geographical areas was undertaken. during pregnancy. GBC poses a clinical dilemma for the clinicians and there is limited information about what is the Aim best management for the mother and her baby. One of the The study aimed to investigate: challenges in studying GBC is that oncology and obstetric care 1. In what ways do rural and remote BCN roles differ to urban is delivered by multiple services, based at different sites. BCN roles? Objectives/Aims 2. What are the range of roles performed by a BCN in the To develop an enhanced network surveillance of GBC and to provision of information and support and to what extent do describe current pregnancy, cancer management, maternal these roles match the Australian Specialist Breast Nurse and neonatal outcomes. Competency Standards. Method Description/Methodology Australian BCNs were recruited using snowball sampling. A prospective population study using Australasian Maternity In 2013, a cross-sectional online survey was developed, Outcomes Surveillance System (AMOSS). AMOSS conducts pilot tested and issued to participants. Statistical data were surveillance and research into rare and serious maternal analysed using SPSS software and qualitative data were morbidity and has a network of almost 300 participating analysed thematically. maternity units throughout Australia and New Zealand (ANZ). Results National Breast Cancer Audit (NBCA) was approached to Fifty BCNs completed the survey, 40% from major cities, 42% identify ways to enhance case ascertainment using their from inner regional Australia and 18% from outer regional, database. Results part-time in their BCN role, with two-thirds having less than 5 NBCA did not collect information on pregnancy and therefore could not be used to identify GBC cases. Following regardless of geographic location. Patterns of service indicated consultation, NBCA agreed to permanently collect information higher caseloads in urban areas, with fewer kilometres served. on ‘gestational status’ in the audit form. BCNs in outer regional, remote and very remote areas spent longer (an hour or more) consulting patients. There were 26 from (7 of 8 states) Australia. Women’s age ranged from knowledge based limitations, limited time, and covering large 23 to 53. geographic areas. Conclusions Conclusions Streamlined surveillance has been implemented to improve Breast care nurses perform a wide variety of roles, with some case ascertainment. Development of ‘gestational status’ in variations according geographical location. BCNs report they do NBCA form will provide ongoing surveillance of women with undertake roles matching the competency standards, however GBC. References 1. Andersson TM et al., 2009, Obstetrics and gynecology, 114(3):568- 572. 2. Ives AD et al., 2005, Breast, 14(4):276-282. Disclosures: Funding gratefully acknowledged from National Breast Cancer Foundation.
27 17th winter congress abstracts friday 25 july
‘I WISH I COULD FIX IT’: SUPPORTING YOUR assessment skills. Currently there are minimal education tools PARTNER THROUGH BREAST CANCER: AN available for nurses working in radiation oncology radiotherapy INFORMATION RESOURCE FOR PARTNERS nursing. In our department the challenge was to provide OF WOMEN WITH BREAST CANCER education for nursing staff new to the specialty. Annie Gayed1, Kathy Wells1, Maxine Morand1 Objectives/Aims 1. Breast Cancer Network Australia (BCNA), Camberwell, VIC, Australia and why? Introduction Adverse Events (CTCAE). on the woman diagnosed, but also on her partner. Research shows that partners often experience levels of distress equal to those experienced by women. Women’s distress usually Description/Methodology falls once treatment has begun, but partners’ distress can Develop a guideline for assessing patients undergoing remain high. pelvic radiotherapy. The guideline addresses potential site Objectives/Aims relevant information, a grading tool based on the CTCAE and This project aimed to address the unmet needs of partners recommended nursing and self-care interventions. to them. The guideline was implemented into our department model of care and trialled by graduate nurses, experienced oncology Description/Methodology nurses and new nursing staff. A background paper was developed to examine existing information resources for partners and their unmet needs. Results The paper recommended the development of an information A simple survey of nursing staff suggests the guideline is an effective education tool for eliciting relevant information, including women diagnosed with breast cancer, male and understanding the CTCAE grading system and increases female partners of women, and a psycho-oncology practitioner, was established to guide the resource development. Feedback from nursing staff suggests the guideline enhances Results consistent patient education, assessment and documentation An information booklet was developed for partners (male and across all levels of nursing experience. female) of women diagnosed with breast cancer within the Conclusions last 12 months. It provides them with information about breast This guideline has provided the opportunity for nursing staff in the cancer, its treatments and common challenges to help them radiotherapy department to align patient assessment, ensure better cope with the diagnosis, and to consequently better consistency in symptom management and documentation thus support the women diagnosed. ensuring positive patient outcomes and staff satisfaction. Conclusions There is a pressing need for information for partners of women EVIQ EDUCATION – SUPPORTING BEST with breast cancer which the new booklet provides. BCNA PRACTICE THROUGH PATIENT FOCUSED needs the vital support of health professionals, including EVIDENCED BASED RADIATION ONCOLOGY cancer nurses, to help us reach women and their partners with this resource. MODULES. Kim Faulkner1, Karen Cooper1, Sarah Graham1, Pauline Rose2, Adam Rutyna3, Margaret Hjorth4, Lisa King1, Catherine Johnson1, Danielle Peterman1 concurrent session e: education for nurses (b) Hospital, Brisbane, QLD, Australia ELICITING KEY CLINICAL INFORMATION – 3. Radiation Oncology, Peter MacCallum Cancer Centre, What to ask and why in Radiotherapy Melbourne, VIC, Australia 4. Radiation Oncology, Epworth Healthcare, Melbourne, VIC, 1 1 Margaret M Hjorth , Roz Bell Australia 1. Ewporth Healthcare, Ballarat, VIC, Australia Introduction Introduction As part of the Commonwealth Government of Australia Better Access to Radiation Oncology funding, the Cancer Institute eliciting key clinical information from the patient is imperative for effective symptom management and positive patient outcomes. radiation oncology education modules linked to the eviQ Radiotherapy nursing requires specialised knowledge and Cancer Treatments Online program.
28 cancer nursing: leading in a time of change abstracts friday 25 july
Objectives/Aims Results To provide education modules focussing on supportive care Interim analysis indicates participants’ stream patients and management. The target audience is radiation oncology cancer into two categories which are either negative or positive. clinicians (nurses, radiation therapists and allied health The words used to portray cancer were destructive, and professionals) who are new to radiation oncology centres. They pessimistic. On examination of data from nursing interactional are also suitable for primary and community care settings. perspective,the language and tones used by the participants that tacit norms and practices and unspoken rules and models Description/Methodology of socially acceptable behaviours were expected of both cancer nurses and patients in this setting. Further exploration nursing, radiation therapists and allied health professionals of social process that govern how cancer and cancer patients interviewed to identify their learning needs. From this, point of in this setting, demonstrated how structural, organisational, societal and health system expectations mediated cancer Five learning modules (Overview of Radiation Therapy, Patient nursing attitudes and practices. case studies - Head & Neck, Colorectal, Lung and Prostate Conclusions cancers) have been developed. These modules have been piloted in the 3 sites by the target audience. reciprocal power relations between nurses, patients and the Results system in which they are embedded shape patients’ behaviour Pilot results indicate that the education modules meet the towards treatment compliance months in radiation oncology) and experienced clinicians EVIQ BRIDGING THE GAP – REAL- reporting the modules were relevant for the clinical setting TIME EVIDENCE RETRIEVAL USING A and target audience. Of the 68 pilot participants, 64 rated the BIBLIOMETRICS SOLUTION 1 1 would recommend the modules to other clinicians. Majority of Catherine Johnson , Lisa King participants indicated that interactive module activities (videos, 1. Cancer Institute NSW, Eveleigh, NSW, Australia Introduction their learning. Conclusion Feedback indicates the modules support the learning needs of oncology where the knowledge base is dynamic. Challenges new radiation oncology clinicians. include time constraints and a lack of search and critical appraisal skills. THE EFFECT OF LANGUAGE ON CANCER eviQ is a widely utilised point of care cancer treatment NURSING PRACTICE resource, providing evidence-based, peer-maintained, best Olayinka Akinsanmi1 practice cancer treatment protocols and clinical information for health professionals and consumers. Objectives/Aims Introduction In 2012-2013, eviQ partnered with Flinders Filters to develop Cancer is a stigma laden condition for both patients and a system to harvest the highest level literature to support clinicians which could have a marked effect on nursing care provided. make relevant evidence more easily and readily available to Objectives/Aims nurses at point of practice. To explore how specialist cancer nurses’ perceive and Description/Methodology construct “cancer” and “cancer patients”, the purpose and Each search was developed and validated through text potential effects on nature of the nursing care they provide in word and MeSH term frequency analysis. This was then one acute oncology setting. tested against a convenience set of references from NCCN Description/Methodology Guidelines. Individual protocol searches were tested against Faircloughs’ Critical Discourse Analysis (FCDA) guided the the retrievals of existing eviQ references. These searches data collection and analysis in this study. Semi-structured were then reviewed by eviQ experts and either approved or interviews of 12 experienced specialist cancer nurses were undertaken in a hospital setting. Stem questions elicited Results participants’ expert knowledge, attitudes and behaviours All search components have been written for use in PubMed towards cancer and cancer patients. Interviews further probed to enable open hyperlinked access allowing more widespread participants’ construct on expectations of patients’ attitudes usage. and behaviour whilst in their care in this high acuity context. Protocols now have a ‘literature tab’, enabling the retrieval of evidence related to that protocol in one mouse click and
29 17th winter congress abstracts friday 25 july
allowing nurses to use these robust literature-searching tools concurrent session f: available through eviQ. Conclusions survivorship eviQ now has a sustainable bibliometrics solution ensuring the latest high level evidence is instantaneously retrieved. This NURSE-LED SURVIVORSHIP CLINIC IN plays a pivotal role in the facilitation of evidence into practice PRACTICE at point of care. Kerry Shanahan1, Bronwyn Flanagan1, Leanne Storer2, Melanie Fisher2, Monique Baldacchino3, QUEENSLAND’S EXTENSION OF EDCAN Susan Thomas2 TO QUEENSLAND-CANCER EDUCATION 1. Royal Melbourne Hospital, Parkville, VIC, Australia PROGRAM (Q-CEP) 2. Western Health, Footscray, VIC, Australia Leisa Brown1, Maree A Bransdon1 1. CIRCS, QLD Health, Bowen Hills, QLD, Australia Introduction Survivorship Care (SC) has gained prominence as the number Introduction of patients disease free after cancer treatment increases and EdCaN was launched in 2008 and provided cancer educators with an evidence-based resource to assist in the development of cancer education. Queensland have taken EdCaN resources This paper presents the practical elements of developing and tailored them to meet the needs of staff involved in caring and managing a nurse-led survivorship clinic. It includes for people affected by cancer across all services. Central Integrated Regional Cancer Service’s (CIRCS) dedication to provide equitable access to standardised cancer education led Aims to the development of Q-CEP using an innovative, blending Aims of the nurse-led SC clinic are to educate and empower learning approach. patients; provide a Health and Wellbeing care plan and co- Objectives/Aims ordinated follow up schedule; and facilitate active engagement To provide: of the GP. Methodology skills necessary to provide safe and effective care to people affected by cancer Hospitals, Western Health, Primary Care Physicians and BreaCan collaborated to implement a comprehensive context such as practice setting and case mix SC program for breast cancer patients 6-12 months post diagnosis. Developed, implemented and evaluated under a Victorian Cancer Survivorship Project Pilot Program, funded graduate learning. by the Department of Human Services. Description/Methodology During the nurse-led consultation the diagnosis history, CIRCS partnered with the EdCaN project team to inform treatment outcomes and follow-up are discussed, psychosocial Q-CEP content and adaptation of the EdCaN capabilities and issues, unmet needs and future priorities addressed, and a learning resources. personalised SC plan developed. To ensure academic rigour, content was derived from EdCaN Results and three core documents were developed: 296 consultations have been completed,74 patients declined invitation. Evaluation included satisfaction surveys with patients and primary care physicians which were very positive. support and specialist nurse roles. Results The provision of a structured comprehensive program in line Conclusion This program continues beyond the project with all sites keen provided educators and participants with tertiary level guiding to embed it into routine practice. Specialist nurses can play documents to enhance participation. an integral role in delivering survivorship care. This work may be transferable to other tumour streams, especially those with Conclusions Implementation of Q-CEP supports recruitment and retention of cancer. skilled cancer nurses are working in Queensland Health facilities.
30 cancer nursing: leading in a time of change abstracts friday 25 july
WOMEN’S EXPERIENCE OF BREAST CARE Objectives/Aims NURSES IN A SURVIVORSHIP CLINIC The aim of this study is to develop the protocol and assess the feasibility of a randomised controlled trial (RCT) that will Lee Kennedy1 1. BreaCan, Melbourne, VIC, Australia Description/Methodology Introduction The study protocol was developed in collaboration with the 184 women participated in a Comprehensive Breast Cancer hospital oncologists, cancer care nurses and cancer support services staff. The recruitment of patients occurred via the Evaluation reveals a high level of consumer acceptance of the Princess Alexandra Hospital, Brisbane. The approach used for initiative and some important feedback on the role of Breast Navigation is the ‘Navigator’ and ‘study nurse’ working as a Care Nurses (BCN). team. Objectives/Aims Results This presentation aims to outline the results of project The study protocol includes the development of a guidebook evaluation pertaining to the BCN role and to highlight further for training Navigators and a ‘step-by-step’ manual to be ways the strong rapport developed between women and BCNs used by Navigators to conduct the screening and address could be utilised for secondary prevention. the patients’ needs. Patients recruited by the Navigator were Description/Methodology assisted through the following actions: education, referral, Acceptability, effectiveness and impact of the process and accompaniment, arrangement, and support. its elements including the Nurse-led clinic process were Conclusions evaluated with a follow up survey to 107 participants with 70 (65%) returned . Twenty telephone interviews with participants effectiveness of an intervention to reduce the inequity in cancer were undertaken to capture qualitative information about outcomes for Indigenous patients. Results of the pilot study will the process, outcomes and impact and to identify areas for inform the development and implementation of the proposed improvement. RCT (the RCT is planned to start in 2015 if funding is granted). Results References A key feature that emerged was the value of continuity of 1. ABS. Canberra: ABS, 2011 (cat. 4704.0.). care from the BCN over the course of their treatment. Patient 2. AIHW & Cancer Australia. Canberra: AIHW, 2013. ratings of the BCN consultations were overwhelmingly positive. 3. Valery PC et al., Lancet, 2006; 367:1842-8. However only 39% reported having made lifestyle changes as a result of their appointment with BCN.
Conclusions DEVELOPING A REHABILITATION While the evaluation has shown a high level of acceptance of FRAMEWORK FOR CANCER SURVIVORSHIP this approach, opportunities exist to utilise the strong rapport 1 1 developed to enhance positive lifestyle change through the Trish Calder , Catherine Carracher use of evidence based interventions such as Motivational 1. Epworth Healthcare, Richmond, VIC, Australia Interviewing. Introduction One of the consequences of cancer treatment is that patients HELPING INDIGENOUS PEOPLE WITH experience a degree of functional decline that impacts on their CANCER TO BETTER NAVIGATE TOWARDS ability to transition back to their pre-cancer lifestyle. There is OPTIMAL CARE: A PILOT STUDY growing evidence that a holistic, multidisciplinary rehabilitation program can improve the quality of life of cancer survivors. In Christina Bernardes1, Gail Garvey1, Phillipa Cole1, the private healthcare sector there is often limited opportunity Patricia Valery1 for multidisciplinary involvement in cancer care and this has 1. Menzies School of Health Research, Brisbane, QLD, implications on patients’ supportive care needs. Australia Objectives/Aims Introduction The aim is to demonstrate the conceptual framework for Indigenous Australians have higher incidence of cancers2, the development and implementation of a cancer survivor higher mortality rates2 and poorer survival compared to other rehabilitation program in a private healthcare institution. Australians3,4. This poor prognosis and the unique barriers Indigenous patients face to access quality cancer treatment Description/Methodology Steps to establishing a cancer rehabilitation program in the private sector: 1. A literature review; 2. Convened a of an intervention that combines navigation, cancer education, multidisciplinary group to discuss the needs of the cohort; 3. and communication coaching. A preliminary framework and business plan was developed; 4.
31 17th winter congress abstracts friday 25 july
Discussion with health insurers regarding rebates; 5. Engaged Phase Two: Qualitative data collection. Selection was researchers for the purpose of evaluating the program; 6. Set purposive. 20 male participants were asked to take part in a a date for an 8-week pilot program and recruited participants to questionnaire and semi structured interview. Results of the program. The results of this study will identify gaps in service delivery Results for men with chronic disease and will inform the development A physical and psychological rehabilitation program with four of recommendations to improve support services for those key concepts integrated in to the design was developed and affected by anxiety and depression. piloted. 1. All participants had 1:1 session with a psychologist; 2. References The exercise program was individually tailored and supervised; 1. Zigmond, AS & Snaith, RP 1983, ‘The hospital anxiety and 3. Single tumour stream, and; 4.Closed group format. depression scale’, Acta psychiatrica scandinavica, vol. 67, no. 6, Conclusions pp. 361-70. The integrated rehabilitation design was well received by participants who valued being able to address both psychological and physical needs as well as being able to plenary session 2 issues. DRESSING AND SECUREMENT OPTIONS FOR CENTRAL VENOUS ACCESS DEVICES: BREAKING DOWN THE BARRIERS: DO THEY WORK, OR ARE THEY JUST MORE EXAMINATION OF THE BARRIERS TO WORK?! PSYCHOLOGICAL SCREENING AND Professor Claire Rickard REFERRAL OF MEN WITH CHRONIC ILLNESS DISPLAYING SIGNS OF DISTRESS Georgina Wiley1 During treatment for oncological or haematological conditions 1. Cabrini Health, Malvern, VIC, Australia CVADs are a necessary device, a resource that we have to nurture and maintain to ensure the completion of essential Introduction therapies for our patients. These patients are already Chronic illness and asociated treatments impose an vulnerable to complications and disability associated with their immense psychological burden on the individual. Provision of underlying health condition. This vulnerability is worsened by information and counselling services has been demonstrated the risk of adverse events associated with the insertion and to be effective in increasing coping ability, reducing levels management of CVADs. of anxiety and depression, and increasing satisfaction with personal participation in medical decision-making to patients Current all-cause failure incidence for CVADs in cancer care across all phases of the illness. Men with chronic illness are has been reported at between 20 and 50% in both adults less likely to report anxiety or depression and it is unknown and children. This includes failure due to local or systemic what barriers may prevent men with chronic illnesses from infection, thrombosis, occlusion and breakage. These failure accepting referrals for psychological support rates suggest that current practices of CVAD management are inadequate. All CVAD failure has a serious multifocal Objectives/Aims impact on the patient’s health. The immediate interruption to 1. Identify the number of patients presenting to a day oncology necessary treatment results in an inability to receive prescribed unit who experience distress. 2. Identify male perceptions towards, and usage of, support medicines. The requirement for insertion of a replacement services and determine the barriers to follow up care with CVAD after failure brings additional risk of dangerous support services. procedural complications. Description/Methodology Evidence-based strategies have been developed to prevent The project is a two phase exploratory study. A mixed method CVAD failure by focussing on different aspects of infectious approach, incorporating both quantitative and qualitative and mechanical complications and their pathogenesis. The research designs, were employed, The sample population ideal CVAD dressing and securement device should: were patients presenting to the Day Oncology Unit at Cabrini 1. provide a barrier protection from colonisation and infection, Malvern for treatment. preventing CVAD-related infection; Phase One: Quantitative research in the form of a questionnaire 2. provide adequate securement to prevent catheter tip which included the collection of demographical information movement, and the Hospital Anxiety and Depression Scale (HADS) from 3. be comfortable and non-irritating for the patient; 231 participants at the Day Oncology Unit at Cabrini Malvern. 4. be easy to use; and 5. be cost-effective.
32 cancer nursing: leading in a time of change abstracts friday 25 july
There is a plethora of CVAD dressing and securement options pathogens compared to the non cancer patient. While Australia from which clinicians may select. These vary from simple does not as yet have the same magnitude of resistance, it is sterile gauze and tape, to suture-less securement devices very important that measures are put in place to manage the and medication-impregnated discs. But which of these risk. Antimicrobial stewardship (AMS) describes the processes strategies have been proven to be effective for patients with that need to be undertaken in order to monitor the emergence CVADs requiring treatment for oncological or haematological of resistance and appropriateness of antimicrobial use, and conditions? Do they work or are they just more work? the measures taken improve patient outcomes and reduce the emergence of resistance. National hospital accreditation FACING AN UNCERTAIN FUTURE: CANCER standards for AMS and the new, as yet to be implemented CARE IN THE ERA OF ANTIMICROBIAL national clinical care standards for AMS will result in improved RESISTANCE quality of care. The role of the cancer nurse in understanding these principles of care will be discussed. In addition, the talk Associate Professor Karin Thursky will provide an overview of the burden and epidemiology of Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. MDR organisms such as vancomycin-resistant Enterococcus Antimicrobial resistance will become a major challenge for faecium (VRE), and MDR gram-negatives clinicians and nurses managing the patient with cancer. and review the potential intervention strategies aimed at Multidrug resistance (MDR) is already a serious problem in addressing their impact; including infection prevention, many parts of the world, in particular Southern Europe and Asia. The rates of infection, neutropenic fever and sepsis in the cancer patient lead to much higher rates of antimicrobial consumption as well the risk of acquisition of resistance
Patients are at the heart of We take cancer personally everything we do at Roche. They motivate and inspire us to search for and develop innovative medicines and therapeutic solutions with the goal of transforming the lives of people with cancer around the globe. We’ve come a long way, but there’s still a long way to go.
Roche Products Pty Limited, ABN 70 000 132 865, 4-10 Inman Road, Dee Why, NSW 2099. EMVROH0091 MN37550651 PreparedJun14
ROH0091 CNSA Handbook 1/2 page ad_FA.indd 1 10/06/14 2:39 PM 33 17th winter congress abstracts saturday 26 july
plenary session 3 personalised cancer treatment ameliorate these health disparities? Clearly health services and systems have a IMPROVING THE PATIENT JOURNEY major role to play in reducing the disparities in outcomes. THROUGH BETTER MENTAL HEALTH CARE: This presentation will highlight the cancer disparities faced CORE BUSINESS FOR ALL NURSES by Indigenous Australians and current research efforts and approaches to reducing disparities across the cancer control Adjunct Associate Professor Kim Ryan continuum. Australian College of Mental Health Nurses, Deakin, ACT, Australia There is a well-documented but complex inter-relationship concurrent session g: between chronic disease such as cancer and mental health, which can represent challenges for nurses in terms of education for patients recognition and management. Mental health problems can reduce a person’s capacity to optimally self manage chronic EXPLORING THE MENOPAUSE AND disease, increase the burden of symptoms of the disease, and FERTILITY INFORMATION NEEDS OF create additional functional impairment. PREMENOPAUSAL WOMEN WITH NEWLY Approximately half of all patients with terminal or advanced DIAGNOSED GYNAECOLOGICAL CANCERS cancer suffer poor mental health. In particular, depression and Jessica Jude1, Martha Hickey1 2, Naomi Thomas1, anxiety are associated with poor treatment adherence, poorer Patricia Nicholson2, Meinir Krishnasamy3 quality of life and an increased risk of morbidity and mortality. 2. University of Melbourne, Melbourne, VIC, Australia poorer quality of life, are less adherent to treatment and have 3. Peter MacCallum Cancer Centre, Melbourne, Australia a diminished will to live. Death rates are as much as 25% Women diagnosed with gynaecological cancers may undergo higher in cancer patients who are depressed and 39% higher treatments that have the capacity to cause permanent infertility in cancer patients who receive a diagnosis of depression. Less and early menopause. This may impact on emotion and than half of cancer patients receive treatment for depression. physical wellbeing of these women. Physical health outcomes are better when a person’s mental The body of evidence pertaining to menopause and fertility health needs are addressed and worse when they are not. information needs of premenopausal female cancer patients The Australian College of Mental Health Nurses Inc (ACMHN) centers on women with breast cancer, with little evidence to has recently undertaken a ‘Chronic Disease’ project, funded inform clinicians of the informational needs of women with a by the Commonwealth Department of Health & Ageing, which gynaecological cancer, prior to commencing treatment included developing eLearning resources for non-mental health This mixed-methodology study set out to explore the nurses, around mental health and chronic disease issues. menopause and fertility information needs of premenopausal This keynote will discuss the issues relevant to cancer and women with newly diagnosed gynaecological cancers. Twenty- mental health and highlight the innovative project that the one women, recruited from a major metropolitan hospital, College has undertaken, in collaboration with colleagues from were invited to participate in a focus group and complete a range of nursing organisations including CNSA, to develop a a satisfaction scale to explore their satisfaction with the high quality, free, online CPD product for nurses. information they received about fertility and menopause prior to commencing their cancer treatment. CANCER CARE IN INDIGENOUS Focus group data was analysed using thematic analysis and COMMUNITIES, WITH ADVANCES IN satisfaction scale results were analysed descriptively using PERSONALISED MEDICINE ARE WE the Statistical Package for Social Science. Key themes were CLOSING THE GAP IN HEALTH OUTCOMES? Associate Professor Gail Garvey Menzies School of Health Research, NSW, Australia impact of treatment on fertility and menopause status. Cancer is a leading cause of death for Aboriginal and Torres Strait Islander Australians. The implications and considerations The outcomes of this study suggest that the development of of the move towards personalised cancer care and treatment resources to address the timely delivery of fertility preservation raises important questions for Australia’s Indigenous people. information, clarity and treatment of menopause symptoms, Firstly, what does this mean in an Indigenous context? Given the challenges Indigenous people face in gaining access to fertility information needs could make a valuable contribution to the wellbeing of these women and prevent decisional regret. between Indigenous and non-Indigenous populations will
34 cancer nursing: leading in a time of change abstracts friday 25 july
“RESILIENCE” SUPPORT GROUP MODEL: CANCER COUNCIL HELPLINE – HOW MANY A TAILORED INFORMATION AND PEER PEOPLE USE THIS INFORMATION AND SUPPORT PROGRAM FOR WOMEN NEWLY SUPPORT SERVICE AND WHY NOT? DIAGNOSED WITH OVARIAN CANCER AND Monica Byrnes1, Jhaike Braham2, Nicola Quin3, THEIR CARERS Sandy McKiernan4, Karen Staal5, Kathy Chapman2 Tarnya Hotchkin1, Jane East1 1. Cancer Council SA, Adelaide, SA, Australia 1. Ovarian Cancer Australia, Melbourne, VIC, Australia 2. Cancer Council NSW, Woolloomooloo, NSW, Australia 3. Cancer Council VIC, Melbourne, VIC, Australia Introduction 4. Cancer Council WA, Perth, WA, Australia Ovarian Cancer Australia has developed a support program 5. Cancer Council QLD, Brisbane, QLD, Australia model for newly diagnosed women, during one of the most challenging stages of their disease. Resilience was developed Introduction in response to women’s feedback and aims to facilitate early The 13 11 20 Helpline lies at the heart of Cancer Council engagement and continued connection. information and support services and is a gateway to a myriad of programs providing informational, emotional and practical Objectives/Aims support. women, ensuring its structure, content and delivery is Objectives/Aims shaped by their needs and preferences. Research was undertaken to understand the reasons for calling the Helpline, satisfaction with the service, and barriers Description/Methodology to using the Helpline. An online survey was developed and distributed via Survey Monkey© to Ovarian Cancer Australia’s survey group, Description/Methodology consisting of women diagnosed with ovarian cancer. A market research company was commissioned to undertake a community attitudes online survey of people touched by The survey explored demographics, the structure and format cancer (n=428) including patients (n=128) and carers (n=300; of the Resilience program, and potential session topics. Results included awareness of Helpline; who referred, awareness of Of the 240 surveys distributed, 73 women responded with the assistance that could be provided by Helpline, and reasons for following preferences: monthly sessions (52%), 4 sessions calling (or not) Helpline. maximum (70%), and a session duration of 2 hours (42%). Results 83% of respondents recognised the importance of peer People affected by cancer reported seeking information mainly through internet (32% of respondents) and doctors (31%). be involved in the program. Only 3% of respondents had contacted the Helpline and 11% had sought information on the Cancer Council website in the cancer diagnosis; its treatment and side effects; clinical trials; last 2 years. Most common reasons for not contacting the and available supports. Helpline was not feeling the need to call, seeking information from doctor or other information sources usually online, and Conclusions low awareness of the service. Women newly diagnosed with ovarian cancer need a support Conclusions needs. Our aim is to implement and deliver a program to The perception of not wanting or needing help is a barrier support, educate and empower women, their partners and preventing calls and there is a need to widen understanding carers, to give them the strength and capacity to adapt well in of the information and support that can be provided by the the face of adversity. Helpline. Knowing more about what is actually on offer would provide people greater clarity about why to call the service. Strategies that engage medical professionals to recommend people call is absolutely critical and should be an ongoing focus.
35 17th winter congress abstracts saturday 26 july
USING WEB-ENABLED TECHNOLOGY TO THE DEVELOPMENT AND EVALUATION OF SUPPORT MEN WITH PROSTATE CANCER RESOURCES FOR FRIENDS OF YOUNG Addie Wootten1, David Blashki1, Helen Crowe2, PEOPLE LIVING WITH CANCER Nicholas Howard1 1, Marika Franklin1, Elizabeth Kelly- 1. Australian Prostate Cancer Research, East Melbourne, Dalgety1, Pandora Patterson1 VIC, Australia 1. CanTeen Australia, Sydney 2. Epworth Prostate Centre, Epworth Healthcare, Richmond, Introduction VIC, Australia Young people living with cancer (YPLWC) report a loss of Introduction connection with friends as one of the key challenges they deal Access to appropriate information and support remains with. Furthermore, research exploring the needs of friends problematic for many men diagnosed with prostate cancer, of YPLWC shows that friends desire to know more about the especially in rural and remote areas of Australia. We have effects of cancer and what they can do to help. developed an online clinical support program, PROSTMATE, Objectives/Aims which aims to overcome these barriers to access. To redress this, CanTeen Australia developed the “Wait…Did Objectives/Aims You Say Cancer?!?” resources to inform friends’ understanding PROSTMATE is a secure portal that provides telehealth of the lived experience of YPLWC and the types of support they consultations with nurses and psychologists, tailored can provide. An evaluation was undertaken to ascertain the information, a place to record treatments, test results and usefulness, utility, satisfaction with, and perceived outcomes appointments, online tracking tools and self-directed support of the resources. programs to improve health and wellbeing. Description/Methodology Description/Methodology A review of the literature and semi-structured interviews PROSTMATE (www.prostmate.org.au) is freely accessible and surveys with YPLWC, their friends and cancer health to men affected by prostate cancer, their families and others professionals, were used to elicit friends’ informational interested in prostate cancer. PROSTMATE launched in requirements and guide the development of the resources. November 2013 and we have monitored its uptake, user The resources developed were then evaluated using two web- engagement and participant feedback. based surveys (one each for YPLWC and friends) sent out six Results weeks after receipt of the resource. Over 500 people have registered. 72% of members are from Results metropolitan areas, 22.5% from regional or remote areas. Overall, the resources were found to be easy to use and The majority of members (56.5%) are men who have been diagnosed with prostate cancer. Self-reported problems at Positive changes in friends’ thoughts and behaviour regarding registration indicated that 17.2% of men with prostate cancer friends’ understanding of, and type and level of support shown reported at risk levels of mood problems and 41.4% reported to YPLWC were evident. at risk levels of sexual intimacy problems. 23.5% of partners Conclusions reported at risk levels of relationship problems and 41.2% CanTeen’s “Wait…Did You Say Cancer?!?” resources were reported at risk levels of sexual intimacy problems. Telehealth shown to be effective in supporting young people’s psychosocial consultations have steadily grown and appear to be an experiences of living with cancer. Nurses’ promotion of the acceptable delivery mode for men and their families. resources can help address the information gap for friends of Conclusions YPLWC and ensure that YPLWC are more fully supported. PROSTMATE shows promise in supporting men and offering access to specialist prostate cancer nurses and allied health services. This paper will explore how PROSTMATE could provide a novel way of improving care, and potentially see the integration of these systems into routine care.
36 cancer nursing: leading in a time of change abstracts saturday 26 july
A SHIFT IN PARADIGM – CENTRAL concurrent session h: INTEGRATED REGIONAL CANCER SERVICE (CIRCS) CANCER EDUCATION PROGRAM supportive care Leisa Brown1, Maree A Bransdon1 THE ROLE OF TEAM LEADER IN PROMOTING 1. CIRCS, QLD Health, Bowen Hills, QLD, Australia SUPPORTIVE CARE SCREENING AMONG Introduction CANCER NURSES. Telehealth improves equitable access to care which is a major Catherine Johnston1, Sara Jorgensen1, Christine Scott1 Remote Care: 2012). CIRCS is committed to providing all health 1. Austin Health, Heidelberg, VIC, Australia professionals with access to evidence based education and support to acquire knowledge and skills necessary to deliver Introduction optimal care for people affected by cancer. The expansion of Telehealth infrastructure across Queensland enabled the cope effectively with cancer, (NCCN, 2013). Screening for evolution of the CIRCS Cancer Education Program. Supportive Care needs is currently not part of routine care; Victoria’s Cancer Action Plan (2008-2011) aims to build Objectives/Aims capacity for supportive care screening, so screening occurs in To shift the paradigm of education delivery from face-to-face 50% of newly diagnosed cancer patients by 2012. to Telehealth by providing access to quality cancer education and information to health professionals regardless of their Aims geographical location. Cancer nurses will routinely and competently screen patients for supportive care needs, provide appropriate support, and Description/Methodology action referrals. The CIRCS Cancer Education Program was initially delivered face-to-face; however this was not sustainable therefore the Methodology option of Telehealth delivery was explored. A team leader was appointed for twelve months to implement a supportive care screening program for inpatient cancer nurses The shift from face-to-face to Telehealth required consideration at a tertiary oncology centre. Nurses participated in education of: sessions on supportive care screening, and were followed up with 1:1 support. Nurses also completed questionnaires pre and post training, to assess knowledge around Supportive Care Screening principles, policies and referral processes, and participated 1:1 interviews. Supportive care screening and interactive learning experience Results Results Over 400 participants attended training offered within the and post questionaires was 20%. At baseline 9 nurses reported CIRCS Education Program in 2013. The program received little knowledge about screening and actioning referrals. Post positive feedback with an average of 4 on a Likert Scale of training 21 nurses reported training had improved practice 1 – 5. Providing interactive Telehealth sessions that equate to around supportive care needs. Training also correlated with face-to-face delivery has seen participant numbers double in improvement in documentation, and how nurses evaluated 2014 with over 20 sites participating at any one time. issues and actioned referrals. Conclusions Conclusion A successful shift in paradigm has been achieved and the The presence of a team leader to support and educate cancer results demonstrate that Telehealth is a viable option to deliver nurses was considered a useful strategy and a positive and quality clinical education across vast distances. effective means of achieving supportive care training.
References 1. National Comprehensive Cancer Network Guidelines(2012), Version 2. 2013 distress management. 2. Department Health Victoria(2008), Victorias Cancer Action Plan 2008-2011
37 17th winter congress abstracts saturday 26 july
DISTRESS SCREENING AND SUPPORTIVE newly diagnosed Victorians with cancer. Cancer survivors and CARE NEEDS OF CANCER PATIENTS AND carers are left on their own to identify and seek help for their CARERS IN REGIONAL WESTERN AUSTRALIA emotional, physical, social, spiritual and information support needs. A research project is currently underway using one of Allison Fosbery1, Louise H Good1, Kaaren J Watts1, the Integrated Cancer Services (ICSs) to examine this issue. Sandy McKiernan1 1. Cancer Council Western Australia, Shenton Park, WA, service. Australia Objectives/Aims Introduction The project aims to develop a new digital information service The role of a regional Cancer Support Coordinator (CSC) that supports people to learn about SC and be guided to is to provide people affected by cancer with supportive care identify their SC needs and where to seek help across all services including: information, practical, and psychosocial stages of cancer journey. support. Our nine CSC have a background in either cancer nursing (n=8) or social work (n=1) and are well equipped for Description/Methodology this role. Cancer Council WA (CCWA) implemented distress As a multidisciplinary and translation research, it uses a mixed screening of new clients accessing our regional CSC, in March methods. The basic research, in two stages, involves using 2013. The implementation process is described, and a case preliminary focus group and pilot clinical trials to survey the study and preliminary distress screening results (Midwest SC needs of people affected by cancer. Software engineering region), are presented. research (notably prototyping) methods are used to analyze SC practices for building an integrated SC learning and screening Objectives/Aims system-tool, and formulating the SC survey questions. Survey To implement distress screening for regional clients and to samples are chosen from one of the Victorian ICSs. report preliminary data on supportive care needs. Results Description/Methodology We have conceptualised and prototyped the architecture CSC received training in distress screening, using the design of an integrated SC learning and screening system- Distress Thermometer and Problem List (DT-PL); screening tool. The preliminary results sugggest that SC is needed by commenced and progress was monitored. The DT-PL was cancer consumers across all stages of cancer journey. administered face-to-face, by phone, or electronically, together with the client assessment form. The CSC reviewed screening Conclusion results with the client and provided support and referrals. This paper provides important insights about SC and its role across the entire cancer journey. The access and availability of Results SC-screening anytime and anywhere is emphasised. Implementation involved: (i) training in distress screening; (ii) start-up and monitoring; and (iii) data collection. Since March 2013, 108 new clients (98 patients, 10 carers - Midwest) SAME SAME BUT DIFFERENT: COMPARISON were screened (M distress = 4.4, SD = 2.7). Physical and OF ONCOLOGY NURSES FAMILY PRACTICES IN AUSTRALIA AND DENMARK most frequently endorsed problem areas were fatigue (62%), Elisabeth Coyne1 , Karin Dieperink2 nervousness (40%). 2. Nursing, University of Southern Denmark, Odense, Conclusions Southern Denmark, Denmark Distress screening of regional clients has been implemented Introduction by CCWA. Physical and emotional problems are priority This study extended previous Australian research to explore areas. Screening will assist cancer nurses and other health oncology nurses family practices in Denmark. The role of the professionals to identify and target clients’ supportive care family varies in different countries. In Australia, family is noted needs. to provide close emotional and physical support (Coyne, 2013). However in Denmark the family may form a less involved role DIGITAL INFORMATION SERVICE AND often decided by the patient (Dieperink, Wagner, Hansen, & CANCER SUPPORTIVE CARE: A VICTORIAN Hansen, 2013). The oncology nurse is the key point of contact PERSPECTIVE for the patient and becomes the gatekeeper to inform tailored support. Chan Cheah1, Sharif As-Saber2, Tracey Tobias1, Selena Sherwell1 Method 1. SMICS, Melbourne, VIC, Australia A comparison of oncology nurses practices in relation to 2. Business School, RMIT, Melbourne, VIC, Australia were conducted with oncology nurses in both Australia and Introduction Supportive care (SC) enables cancer patients to maintain their was conducted. quality of life. However, screening for SC is only available to
38 cancer nursing: leading in a time of change abstracts saturday 26 july
Results Conclusions Across the two countries family assessment formed a part Adequate monitoring processes are essential in ensuring the of the nurses’ initial contact with the patient. In Australia, avoidance of potential adverse effects in Australia. Rather family was often present, however in Denmark this was than pursuing an end-of-life care strategy based on limited often completed just with the patient. In Denmark the nurse evidence, we urge policy makers to continue to invest in provided the main aspect of support and direction for the building the palliative care capabilities of the healthcare family, however in Australia nurses described their role as one workforce, extending the reach of specialist palliative care to identify concerns and refer to a specialist. Similar concerns services and building the palliative care evidence base through of time and space were voiced and that the level of experience investing in rigorous research. Conclusion EVALUATION OF THE GYNAECOLOGY BASIC Whilst family assessment was similar across the two countries, SEXUAL HEALTH ASSESSMENT QUESTIONS INCLUDED IN THE SUPPORTIVE NEEDS engaged in family assessment. The development of simple SCREENING TOOL questions to engage the family may improve overall family Taryn Robinson1, Nicole Kinnane1, Linda Mileshkin1, support. David Bernshaw1 1. Peter MacCallum Cancer Centre, East Melbourne, VIC, THE IMPLICATIONS OF THE WITHDRAWAL OF Australia THE LIVERPOOL CARE PATHWAY IN THE UK Introduction FOR AUSTRALIA: A DISCUSSION PAPER The supportive needs screening tool (SNCT) used at Peter Raymond Chan1 2 3, Jane Phillips4, David Currow5 1. School of Nursing, Queensland University of Technology, only. The original tool contained one question concerning Kelvin Grove, QLD, Australia sexual health issues. Typical questions used for basic sexual 2. Institute of Health and Biomedical Innovation, Queensland health assessment (BSHA) were added to allow sexual issues University of Technology, Kelvin Grove, QLD, Australia to be discussed openly. Aim Australia To evaluate the addition of BSHA questions and describe the 4. School of Nursing, The University of Notre Dame Australia, results. Sydney, NSW, Australia 5. Discipline of Palliative and Supportive Services, Flinders Method University, Adelaide, SA, Australia A retrospective audit of notes was conducted for new patient Introduction The Liverpool Care Pathway (LCP) is an integrated care Results pathway was designed to guide care for people with cancer In total 151 notes were audited. Less than 4% (n=5) had who are in their last days of life. Over the last decade, the LCP entries indicating discussion about the sexual impact of has been widely adopted in various settings across the UK treatment prior to completing the SNST. The nurse coordinator and Australia. In 2013, the UK Government made a decision to completed BSHA for 74% (n=112) of new referrals. Of these, withdraw the LCP in the UK following an independent review. more than half (62% n=69) reported being in a relationship, 8% (n=9) of these being same sex. Less than 10% (n=11) Aims reported decreased sexual interest in the two week time-frame The aim of this paper is to critically discuss the implications of the withdrawal of the LCP for Australia. sexually active. More than a third (37% n=41) reported vaginal Methodology bleeding or discharge . Two thirds (69% n= 77) reported The critical discussion draws on sources from (1) the having been through menopause with 4.5% (n=5) using independent review commissioned by the UK government, (2) hormone replacement. Over half (55% n=62) reported having a Cochrane systematic review recently updated in 2014, and a discussion concerning the impact of treatment on fertility. (3) other relevant literature. Conclusion Results The addition of BSHA to the SNST supports nurse-led discussions about sexual matters with women attending associated with the LCP. Australian institutions should critically for treatment for gynaecological cancer. Timing is critical as identify these issues relevant to them and ensure the standards of care are upheld. Issues warranting further exploration documentation does not equate to no discussion having taken include problems in diagnosing death and communication place. of prognosis, the widespread uptake without evidence from rigorous research and lack of resources dedicated to support the proper use of the LCP.
39 17th winter congress abstracts saturday 26 july
concurrent session i: INNOVATIVE NURSING WORKFORCE STRATEGY.... INCORPORATING AN models of care (b) ENDORSED ENROLLED NURSE INTO A CHEMOTHERAPY DAY UNIT. WESTERN HEALTH ONCOLOGY HOSPITAL Karen Munton1, Angela Mellerick1 IN THE HOME: ISSUES FOR PATIENTS, 1. Chemotherapy Day Unit, Western Health, Melbourne, VIC, CAREGIVERS AND THE HEALTH SYSTEM Australia SPECIFIC TO HOME-BASED CANCER TREATMENT. Introduction The Chemotherapy Day Unit (CDU) at Western Health has Andy Robinson1 traditionally been staffed by Division One Registered Nurses. 1. Chemotherapy Day Unit, Western Health, Melbourne, VIC, Australia the work conducted in the unit did not require a Chemotherapy Introduction Home-based care (HC) is the fastest growing health service opportunity to incorporate an Endorsed Enrolled Nurse (EEN) delivery model in industrialised nations, providing complex into our skill mix. Anticipated expansion of our service will nursing and paramedical treatment to patients in the comfort increase demand for patients to attend our procedure room for of their own homes. Advances in technology and greater radiological and diagnostic procedures. improvements in cancer treatment modalities have made it Objectives/Aims possible to offer some forms of chemotherapy, antineoplastic Our aim was to successfully incorporate, support and expand and supportive treatments safely at home under strict the scope of practice of an Endorsed Enrolled Nurse within conditions. the CDU. Objectives/Aims Description/Methodology To demonstrate service delivery within a home-based care A Clinical Practice Development Nurse was appointed to model, can reduce patient anxiety, decrease hospitalisations educate the CDU staff, coordinate patient and staff satisfaction and ambulatory chair time, increase patient compliance and surveys pre and post implementation of the new role and subsequent satisfaction within the services of Western Health. support the EEN to extend their scope of practice. This Description/Methodology included competency in managing Central Venous Access Using a blend of a case-series quantitative research and Devices’, coordinating care of patients undergoing diagnostic phenomenology qualitative research designs, data collected procedures and completion of the EVIQ Antineoplastic Drug on patient hospitalisation is analysed within the broader Administration Course (ADAC). context of clinical chemotherapeutic administration. This Results data is then synthesised against the context of an extensive literature review, dealing with operational and administrative of the extended scope of practice of the EEN, resulting in management of home-based care delivery. Patient participants competent care coordination, education and discharge planning were also asked to complete a satisfaction questionnaire of patients attending the procedure room. Development of pertaining to home-based cancer treatment, which was these additional skills for the EEN resulted in greater staff compared against similar data gathered from traditional satisfaction and a foundation for incorporating other cancer ambulatory cancer delivery. novice nurses into the CDU. Results Conclusions approximately 1800 home-based care visits were made, an EEN to extend their scope of practice has been a positive resulting in an obvious decrease on demand for traditional experience for all staff within the CDU. ambulatory chair time. The data also indicated an average of 1 visit per month required a hospital admission. The content of the patient satisfaction survey indicates an overall surge in Conclusions Establishing safe chemotherapy administration practices at home may be an effective strategy for decreasing hospitalisation and increasing patient satisfaction and compliance.
40 cancer nursing: leading in a time of change abstracts saturday 26 july
IMPROVING CANCER SYMPTOM AND EXPANDING THE SCOPE OF PRACTICE CHEMOTHERAPY TOXICITY MANAGEMENT OF THE ENROLLED NURSE TO FOR PATIENTS UNDERGOING INCLUDE ADMINISTRATION OF CHEMOTHERAPY AT WESTERN HEALTH ANTINEOPLASTIC AGENTS: KEY ISSUES Angela Mellerick1 AND RECOMMENDATIONS OF THE CNSA 1. Western Health, Footscray, VIC, Australia EDUCATION COMMITTEE 1 2 3 Introduction Kylie Ash , Alayne Reid , Catherine Pigott , 2 4 5 As delivery of chemotherapy is increasingly transferred to the Elisabeth Coyne , Heather Pearse , Kate Baychek , 7 8 outpatient setting, patients and families are faced with the Leisa Brown , Lucy Patton , Danielle Peterman , 9 10 challenges of managing cancer symptoms and chemotherapy Elisabeth Black , Liz Pascoe toxicities at home. A 6 month analysis of patients undergoing 1. QUT, Kelvin Grove, QLD, Australia chemotherapy revealed 40% of patients presented to ED for cancer symptom or chemotherapy toxicity management on at 3. Peter MacCallum Cancer Centre, Melbourne, VIC, least one occasion. Of these patients, 36% were discharged Australia directly from ED with a further 20% discharged within 24 hours. 4. Calvary Healthcare , Adelaide, SA, Australia Objectives/Aims 6. Central Integrated Regional Cancer Services, Brisbane, Development of a Symptom and Urgent Review Clinic (SURC) QLD, Australia in the Chemotherapy Day Unit (CDU) with dedicated space 7. Fiona Stanley Hospital, Perth, WA, Australia and personnel to manage patients who experience cancer 8. Cancer Institute NSW, Sydney, NSW, Australia symptoms and chemotherapy toxicities. 9. St Vincents Health Network, Sydney, NSW, Australia Description/Methodology 10. La Trobe University, Bundoora, VIC, Australia Consultation with stakeholders including radiology, pathology, Introduction bed management ED, surgical units to develop clear and In response to the increased demand for antineoplastic agents agreed pathways for patients presenting to the SURC Development of a comprehensive triage tool to guide decision the scope of practice of the Enrolled Nurse (EN) has been making around telephone advice and management of patients expanded to include administration of antineoplastic agents presenting to the unit for care. AAs in Australia poses safety concerns for both cancer patients Development of an Advanced Nursing Practice (ANP) role to and the nurse. triage patients either by phone or face to face. Utilisation of the existing medical resources within the CDU to support the Objectives/Aims ANP role. This paper presents the review completed by the Cancer Nurses Society of Australia (CNSA) Education Committee. Results 5 months since its commencement, SURC has had 206 Description/Methodology telephone consults and 208 clinic attendances. Only 6% of A review of literature and current policies was completed these patients have required inpatient admission indicating better outpatient management of symptoms. Surveying of outlining the key issues and recommendations was developed patients has revealed the majority would otherwise have for the CNSA National Executive Committee. Key focus areas presented to ED. 98% patients reported very high satisfaction with SURC. scope of practice. Conclusions Results Provision of a SURC model of care can reduce ED presentations and give patients undergoing chemotherapy a the nursing workforce. Changes to care delivery must consider more favourable experience. the capabilities of the health service, nurse sensitive patient outcomes and ensure patient safety. Stratifying antineoplastic agents into groups according to administration complexity is one approach which requires further exploration. There is no professional framework or competencies currently supporting EN administration of AAs. A framework to guide the RN in issues such as delegation, appropriate supervision, and clarity of scope of practice and support for the EN is required.
41 17th winter congress abstracts saturday 26 july
Conclusions HOW DO PROSTATE CANCER SPECIALIST NURSES’ PROFESSIONAL DEVELOPMENT administration of AAs. A framework for nurses which provides NEEDS CHANGE OVER TIME? guidelines for scope of practice, delegation and supervision is Julie Sykes1, Wei-Hong Liu2, Danette Langbecker2, required to ensure safe and sustainable practice for the cancer Patsy Yates2 patient. 1. Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia “LET’S TALK ABOUT SEX ” – THE 2. Queensland University of Technology IHBI, Brisbane, QLD, IMPLEMENTATION OF A NURSE Australia PRACTITIONER (NP) LED SEXUAL HEALTH Introduction AND ERECTILE DYSFUNCTION (SHED) CLINIC In 2012, Prostate Cancer Foundation of Australia established AT PETER MACCALLUM CANCER CENTRE a prostate cancer specialist nursing service, which funds (PETER MAC) placement of nurses in hospitals across Australia in partnership Kath Schubach1 with health service providers. Nurses were provided with 1. Peter Mac, East Melbourne, VIC, Australia continuing professional development and peer support. Introduction Objectives/Aims Sexual dysfunction is often under diagnosed and We aimed to understand how nurses’ professional development underappreciated particularly in a cancer population. A needs changed as they worked in the role. diagnosis of cancer and potential treatment options can Description/Methodology impact greatly on patients and their partner’s quality of life. The In online questionnaires at the beginning and mid-point of the importance of addressing patient’s sexual concerns can have program, nurses rated their levels of professional competencies a positive effect on their wellbeing. on a 5-point scale against their practice framework, in four Objectives/Aims domains: provision and coordination of care; collaborative and The development and implementation of a NP sexual health therapeutic practice; professional practice; and critical thinking and erectile dysfunction clinic aims to provide comprehensive and analysis. care to cancer patients experiencing sexual health issues. Results Description/Methodology All 12 nurses completed both questionnaires. Overall, in each The clinic was established following a clinical research project sub-domain, >50% of nurses reported their competency levels improved or remained stable. The greatest number of nurses to meet patient’s sexual concerns. The clinic is available to reported improved competency levels in: identifying adverse patients with a cancer diagnosis who have concerns or issues effects of cancer and therapies; providing access to supportive relating to erectile dysfunction and sexual health. care services and interventions; and initiating ongoing improvements in collaborative relationships with patient and Results healthcare teams. The fewest number of nurses reported The NP led sexual health and erectile function clinic was competency improvements in three areas: participating in established in 2012. Approximately 150 patients have attended activities contributing to reducing the risk of developing cancer; the clinic. More than half of the patients attended with their identifying health needs of the person affected by cancer; and partners. The majority of patients had a diagnosis of prostate, developing therapeutic relationships with people affected by colorectal and haematology cancers. The common treatment cancer. interventions are oral therapy, penile injection and vacuum erectile device therapy. Conclusions A program comprising continuing professional development Conclusions Sexuality is a fundamental aspect of every individual. The core areas of specialist practice. This model’s applicability to NP led sexual health and erectile dysfunction clinic involves other groups should be investigated. utilising expert knowledge and clinical skills to assess, diagnose, educate and manage patient’s sexual health issues. This will provide patients with information to make an informed decision about how to manage their sexual concerns.
42 cancer nursing: leading in a time of change abstracts saturday 26 july
plenary session 4 DEVELOPING COMMUNITY PATHWAYS FOR PEOPLE LIVING WITH AND BEYOND CANCER Dr Theresa Wiseman The Royal Marsden NHS Foundation Trust, London, UK Advances in cancer research and treatments have led to more people living with and beyond cancer. Macmillan estimate that by 2020, 1 in 2 people will get cancer; almost 4 in 10 won’t die. Many cancer patients complete their primary treatment and return, more or less, to the same level of health and wellbeing that they enjoyed before their diagnosis. However, 53% people surveyed 6 months after cancer treatment had moderate or severe unmet needs. At present Follow-up care is focussed on monitoring recurrence and is based in the hospital setting. Yet recurrence is rarely picked up in routine follow up. In fact further lumps as they know they are due for a routine appointment. Existing services focus on acute phase which can leave patients feeling abandoned at the end of treatment, “usual” life. We need a model which risk care into community. The purpose of this project was to develop and pilot a model of care which focused on the transition from acute services into the community. Seven roles were tested: support workers in the hospital (2) and a specialist cancer community team (5). alongside a generic This paper sets out the care pathways and new roles; highlights what worked well and what worked less well; and details lessons learnt and future recommendations.
43 17th winter congress poster abstracts
1. A SEVERE DOCETAXEL SKIN REACTION: A CASE REPORT of CNS’s, undertaken by two CNS’s working within the MBC specialty. Gillian Blanchard1 1. Calvary Mater Newcastle, Waratah, NSW, Australia Results Key areas of supportive care provision were co-ordinated Docetaxel is a microtubular agent used in a variety of cancer care, timely information and assessment of need. The CNS treatments. In recent years it has become commonplace in the role is pivotal in meeting these areas of supportive care and adjuvant treatment of breast cancer. spans the gap between specialists in the hospital setting and Many conventional chemotherapy agents are reported as community services so patients are supported to live as well as having the potential to cause Hand Foot Skin Reaction (HFSR), possible and access treatments and interventions with ease, in including Docetaxel a timely fashion. It has been our experience that severe skin reactions from Conclusions Docetaxel are a rare event and present mainly on the extremity Although specialist nursing services for MBC are in their used to infuse the drug. A literature review of both Medline infancy the momentum started by Breast Cancer Care and and the Cochrane data base did not reveal any reports of others needs to be maintained to promote the best possible Docetaxel skin reaction without extravasation, nor were there support to this group of patients as more treatments are any case reports of HFSR from single agent Docetaxel use. developed. Cancer nurses involved in the care of patients with The Landmark FNCLCC PACS01 trial of sequential FEC-D MBC should challenge the service provision and may need to start exploring different models of care, such as non face- to -face care and support. This report is our institutions experience of a 66 year old female receiving adjuvant Docetaxel in October 2013. After infusion of her third Docetaxel within 24 hours she developed 3. PROMOTING AWARENESS IN QUALITY G3 HFSR with severe skin changes with bilateral erythema, RADIOTHERAPY NURSING blistering and pain. This occurred untypically on the tops of Kathryn Watty1 both of her hands resulting in limiting both instrumental and self-care ADL’s. Australia Our patient was treated with oral anti-biotics, steroids and Introduction topically with Mepilex Foam Dressing which is commonly used Eastern Health Nursing Education and Peter Mac Box Hill to treat radiation desquamation. Analgesia was commenced Radiotherapy Nurses recognised a gap in knowledge, of by the GP. The wound was assessed every other day and was radiotherapy, by nurses working in medical oncology in an acute dressed for 24 days. By day 29 only mild scaling of the skin hospital setting. A project involving the implementation and remained and functional ability had returned to pre-treatment evaluation of a one day program called ‘A Day in Radiotherapy capacity. Nursing” was undertaken Objectives 2. CO-ORDINATION OF SUPPORTIVE CARE The project aimed to enhance the understanding and NEEDS IN METASTATIC BREAST CANCER knowledge of radiation oncology nursing to optimise best patient Melissa Warren1 2, Diane Mackie2 outcomes. The objective was to work towards standardising 1. Capital and Coast District Health Board, Wellington, New care for oncology patients undergoing radiotherapy across Zealand Eastern Health. This was to be achieved through educating 2. The Royal Marsden NHS Foundation Trust, London, oncology nurses about radiotherapy techniques, side-effects United Kingdom and best-practice strategies to manage patient care Introduction Description Metastatic breast cancer (MBC) is increasingly acknowledged A one hour Radiobiology lecture was presented to nurses at as a separate disease and this review highlights the often Eastern Health on four occasions through the year. unique characteristics and supportive care needs of patients Twelve Nurses from an Eastern Health medical oncology ward with MBC and the role of the Clinical Nurse Specialist (CNS) in spent a single day at Peter Mac Box Hill attending a seven co-ordinating their care. hour program. Feedback was sought using the developed Objectives/Aims evaluation tool To advance cancer nurse’s knowledge on the supportive care Results needs of patients with MBC and the role of the CNS in co- Feedback from twelve nurse participants and both Eastern ordinating their care. Health Nursing Education and Peter Mac Radiotherapy Staff Description/Methodology was overwhelmingly positive with strong support for the A review of the literature on the supportive care needs of initiative to be ongoing .Measures showed that knowledge of patients with MBC drawing on the standards of care developed radiotherapy increased after the nurse undertook “A Day In Radiotherapy”. 44 cancer nursing: leading in a time of change poster abstracts
Conclusions 5. PERIPHERALLY INSERTED CENTRAL Formal collaboration and a professional relationship has been CATHETER (PICC) CUSHIONING MATERIAL: developed and strengthened between Eastern Health and A PILOT STUDY COMPARING GAUZE WITH Peter Mac Box Hill by the sharing of knowledge, including the SILICONE FOAM FOR CHEMOTHERAPY latest evidence based, best practice in radiotherapy nursing. PATIENTS The program continues to be offered in 2014 to Eastern Health Kerrie Curtis1, Cherene Ockerby1 2, Paul Bennett1 2, Nurses. Ellen Heywood1, Linda Marshall1 1. Monash Health, Melbourne, VIC, Australia 4. MY JOURNEY AS A NOVICE RESEARCHER: 2. Deakin University, Melbourne, VIC, Australia A JOURNEY WORTH TAKING! The distal portion of a peripherally inserted central catheter Rachel Pitt1 (PICC) can cause pressure and subsequent loss of skin 1. Manning Cancer and Palliative Services, Manning integrity when contained under the transparent dressing Hospital, Taree, NSW, Australia unless there is a cushioning layer between the PICC and skin. Introduction This pilot study compared two different materials, their impact Professionally, research forms a component of senior cancer on nursing practice and the skin of oncology patients. Sterile gauze is used to cushion the PICC line when replacing to undertake research, as access to academic institutions is the weekly PICC dressing. This is in line with organizational limited by geographic isolation. As ground level practitioners guidelines. However the use of gauze is not consistent and patient advocates we are often in a position to see the with international recommendations which recommend need for sound research to inform change to improve patient replacement of gauze dressings every 24-48 hours (Grady et outcomes. al, 2011, CNSA, 2007 and INS, 2011). The aim of this study Objectives/Aims was to compare a silicone foam material with gauze using This abstract describes a personal experience of a cancer three primary measures: ease of removal, skin irritation and nurse as a novice researcher undertaking a research project itch. in conjunction with the Rural Research Capacity Building Patients (n = 40) were alternately allocated to the silicone foam Program (RRCBP) run by the Health and Education Training or gauze group. Each of the three outcome measures was Institute. given a rating from 0-2 with 0 being the most positive response Description/Methodology (i.e. dressing easily removed, no skin irritation, and no itch). The RRCBP builds research skills in the NSW rural workforce Data was collected weekly, over four consecutive weeks. through a work based novice researcher development program The results for the silicone foam group were more positive and through this I undertook a qualitative research project that for each of the three outcome measures compared to the sought to better understand the experience of the rural patient gauze group. The silicone foam material reduced the odds insight into the personal challenges and breakthroughs, navigating the project from initial application to completion The silicone foam cushioning material is equal, and possibly superior to gauze. interviews, transcription, thematic and analysis and writing the References: Results The RRCBP has provided a structured and supportive environment for a novice researcher to produce research that htm has the potential to shape future practice. It develops many workplace skills including critical thinking skills. Conclusions The RRCBP provides a unique opportunity for rural cancer nurses to participate and learn how to do translational research; Research that has tangible outcomes that can be used for the
45 17th winter congress poster abstracts
7. PSYCHOSOCIAL NURSING INTERVENTIONS STORY? IMPLEMENTING SCALP COOLING IN FOR PATIENTS WITH CANCER AN AUSTRALIAN SETTING. Giselle Ciavarella1, Bernice Redley1 2, Beverley Kerrie Andrews1, Fran Boyle1, Jenny Gurton1, Wood1 2, Mari Botti1 2 Amanda OReilly1 1. Epworth Freemasons, East Melbourne, VIC, Australia 1. Mater Hospital, North Sydney, NSW, Australia 2. Deakin University, Burwood, VIC, Australia Meeting the psychosocial needs of people with cancer and their of distress, physically and psychologically and should not be families is challenging for nurses in busy inpatient settings. underestimated in women with early breast cancer( EBC)1,2 This study investigated nurses’ understanding of best practice guidelines for psychosocial care in adult cancer and their self- Scalp cooling technology for prevention of CIA during perceived skill in utilising them in practice. appropriate treatment regimens (eg TC and FEC-D in EBC) has been standard of care throughout Great Britain and Europe for The study aimed to understand and identify the importance over 10 years. Uptake in Australia has been low until recently, nurses place on intervening with patient and family members when new generation coolant circulating devices have become psychosocial needs and their self-perceived skill level in available (Paxman, Dignitana). Recent publications of data meeting those needs. Nurses’ preferred form of education from the Dutch registry have been reassuring regarding safety delivery was also explored. 3 and patients are accessing information about this A two-stage study utilised a mixed-method design within a approach with interest. large, acute-care private health service. In stage 1, 46 nurses The Mater Hospital North Sydney, commenced scalp cooling completed a survey, based on the work of Frost, Brueggen with Penguin Cold Caps in 2010 for women with EBC. Digitana and Mangan (1997) and the Clinical practice guidelines for and more recently Paxman devices have been subsequently the psychosocial care of adults with cancer (National Breast introduced. Barriers addressed have included funding of Cancer Centre and National Cancer Control Initiative 2003). In stage 2, 13 frontline clinicians participated in three focus scheduling and chair time, hair care and patient comfort and group interviews that further explored nurses’ views. Ethics support. A prospective audit of our initial experience with scalp cooling4, While nurses recognised the importance of patient and family reported 50% of patients on Deans Alopecia scale had Grade needs for psychosocial care, they were not well informed 2 or less hair loss when receiving standard dose Docetaxol about best practice guidelines and perceived their skill to be moderate to low. Local in-service was the preferred method EBC. Currently cooling has been extended to metastatic breast of education delivery. Key barriers included time constraints, and prostate cancer patients receiving Docetaxel. Feedback work environment and access to education. from patients has been encouraging, highlighting a greater sense of control and improved body image. of nurses who care for patients with cancer. The outcomes may Scalp cooling is now established at our facility and we are have broader relevance for the preparation of nurses to deliver actively assisting with the establishment of scalp cooling psychosocial care to patients receiving cancer treatment. at other centres. We are also participating in international References research developing better measurement tools for the impact 1. Frost, MH, Brueggen, C & Mangan, M 1997, ‘Intervening with the of CIA and scalp cooling. psychosocial needs of patients and families: perceived importance and skill level’, Cancer Nursing, vol. 20, no. 5, pp. 350-8. References 2. National Breast Cancer Centre and National Cancer Control 1. Van den Hurk C, et al. Impact of alopecia and scalp cooling on the Initiative 2003, Clinical practice guidelines for the psychosocial care well-being of breast cancer patients. Psycho-Oncology 2010; 19: of adults with cancer, Camperdown, NSW. 701-09. 2. Breed W, et al. Presentation, impact and prevention of chemotherapy-induced hair loss: scalp cooling potentials and limitations. Expert Review of Dermatology 2011; 6: 109-25. 3. Van den Hurk et al, Impact of scalp cooling on chemotherapy induced alopecia, wig use, and hair growth of patients with cancer. 4. Boyle et al, COSA 20143
46 cancer nursing: leading in a time of change poster abstracts
8. WHO ARE TODAY’S LEADERS? Description/Methodology Renee Norman1, Karen O’Dell Women who had surgery and chemotherapy for breast cancer 1. The Queen Elizabeth Hospital, Woodville, SA, Australia were invited to attend a focus group. Two focus groups were held and a total of 10 women attended. Questions were asked Introduction about the type of venous access device and why this was With the ongoing evolution of more complex, aggressive information was given. The focus groups were recorded and specialty and, as organisations, from necessity, move to a more following verbatim transcription two researchers independently read the transcripts and coded themes and subthemes. Oncology nurses increase. Are we ready to lead? Current training provides the basis for nurses to enter the workforce Results and practice their profession and the workplace allows for the The themes that emerged were that before starting development of these basic skills to a higher level of knowledge chemotherapy it was a blur and overwhelming and women and expertise however, how are nurses learning to lead? unsure if they were given oral or written information about venous access devices. During chemotherapy the theme of Objectives/Aims familiarisation emerged with the access devices, blood tests This study sought to identify: Who do nurses recognise as and a feeling of safety of having treatment and also know that leaders? What leadership qualities do nurses expect within a PICC or port could be used if in hospital. On completion of leaders? Who inspires today’s nurses? The study also sought to identify the nurses’ perception of their role within the and having their venous access device removed, which women leadership structure of their ward. who had a port stated could be traumatic. Description/Methodology Conclusions nurses in an inpatient acute care hospital setting in South ports and cannulas to be given to women. Guidelines to be Australia. 35 registered and enrolled nurses were surveyed, developed as to who needs a PICC or port. with their experience ranging from newly graduated nurses to nurses with experience of 20 plus years. 10. PROSTATE CANCER SPECIALIST NURSES Results – INFLUENCING CARE BEYOND THE BEDSIDE After extensive feedback from participants no contemporary Julie Sykes1 1. Prostate Cancer Foundation of Australia, St Leonards, NSW, Australia leader. Participants were hesitant to acknowledge themselves as leaders. Introduction The PCFA Prostate Cancer Specialist Nursing (PCSN) service Conclusions has been operational since 2012 and currently consists Nurses do not necessarily see themselves as leaders and of 12 nurses located across Australia. Since the program tend to recognise a structure of management as leading their commenced, the specialist nurses have been involved in practice. It is necessary to recognise leadership is a quality variety of strategic activities. This has been in their local areas required in all nurses. and also on a state and national level alongside their clinical work. 9. PICCS, PORTS AND PERIPHERAL Objectives/Aims CANNULAS – THE PATIENTS’ PERSPECTIVE The aim of the strategic role is to improve the quality and Alison Szwajcer1, Rosemary Hannan1, Liane standard of care delivered to men with prostate cancer, O’Brien1, Marie Fournaris1, Patricia Bastick1, Ritin through improvements at a systems level and in additional to Fernandez1 their patient care roles. 1. St George Hospital, Kogarah, NSW, Australia Description/Methodology Introduction Prostate Cancer Specialist Nurses are involved in a wide Many women who have breast cancer will require chemotherapy range of activities; including research, quality improvement as part of their treatment. Nurses are often the ones to assess and participation in education at a local and national level. womens’ veins and can give information about different venous access devices. Results Examples of these activities include the provision of education Objectives/Aims sessions to peers and medical staff within their organisation, at To explore womens’ experiences of the venous access devices conferences, within the primary care setting and through formal used in the administration of their chemotherapy. activities and programs, such as presenting at The PCFA Rural
47 17th winter congress poster abstracts
Education Roadshow. The Roadshow allows the Prostate Conclusions Cancer Specialist Nurse to delivery education sessions to rural regions in all states and territories in Australia. The PCSN team the care and coordination of patients attending the CDU and are also involved in Quality Improvement activities led through staff satisfaction has improved. PCFA. Conclusions 12. DABRAFENIB, A NEW ERA - TARGETED The purpose of these strategic activities is to provide awareness THERAPIES AND SIDE-EFFECTS. and education to the wider communities impacted by prostate Theresa Nielsen1, Lydia Visintin1, Margaret Whitton1 1. Royal Prince Alfred Hospital, Camperdown, NSW, Australia care experience. Introduction The drug Dabrafenib has recently been added to the PBS 11. EXTENDING THE SCOPE OF PRACTICE and is used for the treatment of unrespectable Stage IIIC & OF AN ENDORSED ENROLLED NURSE IN A IV melanoma positive for V600 BRAF mutation. It is an oral CHEMOTHERAPY DAY UNIT.... WHAT CAN THEY DO? signalling pathway in melanoma cells that is overactive due to Jade Roether1 a mutation in the gene called BRAF. The most common side 1. Chemotherapy Day Unit, Western Health, Melbourne, VIC, effects are drug related fevers and skin toxicities. Australia Objectives Introduction The Chemotherapy Day Unit (CDU) has traditionally been standard chemotherapy. Establishing and implementing an staffed by Division 1 Registered Nurses (RN Div 1). Patient educational program for staff and patients is a key feature in early detection and effective management of side effects. It is care other than chemotherapy administration taking up time of important to empower patients, their families and carers with highly skilled chemotherapy trained nurses. Patients attending the knowledge of recognising symptoms. the CDU for radiological and diagnostic procedures could be Description managed by an Endorsed Enrolled Nurse (EEN) with the right support. carers by the Melanoma Clinical Nurse Consultant. Side effects Objectives/Aims and management are discussed as well as the importance of contacting the CNC or after-hour’s on-call oncology registrar if practice of an EEN under the supervision of a RN coordinating patients experience any symptoms. An information brochure the care of patients attending the CDU for procedures. was developed for patients being treated with Dabrafenib which highlights the management of fevers and skin reactions. Description/Methodology A dedicated Clinical Practice Development Nurse was Results appointed to support the EEN to extend their scope of practice Early reporting of side effects allows for better management within the CDU. of patient care and minimizes possible hospital admissions. Utilising the expertise of the Dermatology team including the Patient and Staff surveys were conducted to establish a CNC to assist with the management of skin toxicities has made an enormous impact on patient and quality of life. the CDU staff. Conclusions A skills assessment was conducted enabling targeted learning Treatment for stage IIIC & IV unrespectable melanoma has opportunities for the EEN to extend their scope of practice changed dramatically in the past 4 years. The introduction of within the CDU. new therapies and recent PBS listing of Dabrafenib provides Results patients with improved survival outcomes. The side effects and 5 months post implementation of the EEN role there has been: management of targeted therapies differ from chemotherapy. CDU, diverting the work from an RN Div 1. an initial task list of 52 activities to 161. improved with 88% of staff indicating they want the EEN to remain permanently.
48 cancer nursing: leading in a time of change poster abstracts
13. ONLINE PATIENT-HELD RESOURCES FOR Wiki. They are currently being piloted to assess acceptability IMPROVING CANCER PAIN MANAGEMENT and utility and inform further development. M Lovell1 2, T Luckett3 4 5, N Marie4, M-R Birch1, Conclusions J Stubbs , J L Phillips2 4 7, F Boyle2 8, M Agar1 5, Implementing evidence-based cancer care requires strategies A Green4, P M Davidson4 9 across patient, provider and healthcare system levels6. Patient 1. Hammondcare, Sydney, NSW, Australia resources will be tested alongside other strategies in a future 2. Sydney Medical School, The University of Sydney, Sydney, randomised controlled trial. NSW, Australia References: 3. Improving Palliative Care through Clinical Trials: ImPaCCT, 1. Cancer Council Australia. Overcoming cancer pain: A guide for Sydney, NSW, Australia 4. Faculty of Health, University of Technology, Sydney, NSW, Australia Overcoming-Pain-NSW-Lores2.pdf. Accessed 18th February, 5. South Western Sydney Clinical School, University of New 2014. South Wales, NSW, Australia 6. CanSpeak, NSW, Australia Australian survey of current practice and guideline use in adult 7. Cunningham Center for Palliative Care & University of cancer pain assessment and management: Perspectives of Notre Dame Australia, Darlinghurst, NSW, Australia 8. The Patricia Ritchie Centre for Cancer Care and Research, 3. Luckett T, Davidson PM, Boyle F, Liauw W, Agar M, Green A, Mater Hospital, Sydney, NSW, Australia Lovell M. Australian survey of current practice and guideline use in 9. School of Nursing, Johns Hopkins University, Baltimore, adult cancer pain assessment and management: Perspectives of USA Introduction Assessment and management of adult cancer pain: a systematic Cancer pain is a common distressing problem that is under- review and synthesis of recent qualitative studies aimed at treated due to numerous healthcare system, provider and developing insights for managing barriers and optimizing facilitators consumer barriers. The current team adapted international guidelines for use in Australia and embarked on research to Manage. 2013;46:229-253. 5. Marie N, Luckett T, Davidson PM, Lovell M, Lal S. Optimal patient Aim education for cancer pain: A systematic review and theory-based To develop a patient-level strategy to support evidence-based, person-centred care for pain, complemented by an existing patient pain education booklet available from the Cancer Patient education, coaching and self-management for cancer pain. Council Australia(1). Description/Methodology 14. NURSE CARE GUIDES – A The following methods were used to inform optimal content of COMMUNICATION, EDUCATION AND the patient-level strategy: DOCUMENTATION TOOL 1. An online survey of current practice;(2,3) Linda McGinn1, Margaret Hjorth1 2. A systematic literature review meta-synthesis of qualitative 1. Epworth Healthcare, Richmond, VIC, Australia studies concerned with barriers and facilitators to cancer Introduction pain management;(4) Epworth Healthcare introduced care guides as part of its 3. A systematic review and theory-based meta-analysis of the ongoing commitment to provision of high quality patient care. effectiveness of patient education for improving cancer pain The care guides include key elements of evidence based (5) outcomes; care to ensure consistent care delivery, documentation and 4. Clinical process mapping and patient interviews at a single communication across all care settings. The introduction of palliative care unit. equivalent care guides has had a positive impact on patient outcomes at other health institutions (Medves, Godfrey et. Al., Results 2009). Results indicated that resources should be developed to help patients reframe their pain as controllable to enhance self- The majority of patients receives radiotherapy in the outpatient setting, however up to 20% will be admitted to hospital for management and care coordination, and expect and advocate symptom management and supportive care. It is recognized for person-centred evidence-based care from their medical team. A pain diary, self-management plan, and tools to support accordingly. available on the Cancer Council Australia Cancer Guideline
49 17th winter congress poster abstracts
Objectives/Aims Outcomes To develop a tool that assists staff to deliver a high standard of Chemo@home, a domiciliary chemotherapy service was established in the Perth metropolitan area over the past 12 radiotherapy. months. It integrates with current treatment strategies and is now transitioning as standard cancer care for patients. Description/Methodology Results To date over 500 treatments have been delivered with overwhelming positive satisfaction from patients and participating medicos. The service is expanding to other specialised medical areas and it is anticipated that this type reference during an admission. of domiciliary infusion service will soon become the norm for Results patients with cancer and other chronic illnesses. Radiotherapy care guides have been developed and implemented into clinical practice for inpatients at Epworth AUSTRALIAN CONSENSUS GUIDELINES FOR delivery of evidence based patient care, they are also an THE SAFE HANDLING AND ADMINISTRATION excellent communication tool to aid in care planning, while inadvertently educating health practitioners in radiotherapy OF MONOCLONAL ANTIBODIES FOR CANCER patient care principles. TREATMENT BY HEALTHCARE PERSONNEL M. Alexander1, J. King2, A. Bajel3, C. Doecke4 5, Conclusions P. Fox , S. Lingaratnam1, J.D. Mellor1 8, The development of tools such as care guides are an effective L. Nicholson9, I. Roos10, T. Saunders1, J. Wilkes11 12, way to address gaps in health practitioner knowledge as R. Zielinski , J. Byrne13, K. MacMillan2, A. Mollo2, patients move between the inpatient and outpatient setting. S. Kirsa1 and M. Green2 1. Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia HOME – AN INTEGRATED MODEL OF 2. Western Health, Footscray, Victoria, PATIENT CENTRED SERVICE DELIVERY FOR 3. Royal Melbourne Hospital, Melbourne, Australia, CHEMOTHERAPY PATIENTS 4. Royal Adelaide Hospital, Adelaide, Australia, Lorna Rogers1, Julie Wilkes1, Zelda Haskins1, Stacy 5. School of Pharmacy and Medical Sciences, University of McGreal1 South Australia, Adelaide, Australia, 1. Chemo@home, North Perth, WA, Australia 6. Central West Cancer Service, Orange, Australia 7. University of Western Sydney, Sydney, Australia Introduction 8. Roche Pty Ltd, Melbourne, Australia A staggering one in two people will experience cancer by the 9. Royal Hobart Hospital, Hobart, Australia time they reach 85 years of age. The impact on patients and 10. Youth Research Centre, University of Melbourne, the health system demands new service delivery models. Melbourne, Australia Home based chemotherapy addresses not only hospital 11. View Health Pty Ltd, Perth, Australia capacity issues, but also assists patients and their families, 12. Chemo@home Pty Ltd, Perth, Australia especially those at risk of sub optimal outcomes due to gaps 13. Western and Central Melbourne Integrated Cancer in the current service delivery model. In WA, a new model of Service (WCMICS), VIC, Australia care for home chemotherapy treatment has been established and evaluated. Introduction Monoclonal antibodies (MABs) are rapidly emerging into Aim clinical oncology and haematology practice. Healthcare To outline the need for, and the establishment and evaluation personnel have few available resources to evaluate risks and of “Chemo@home”, a home-based chemotherapy service. inform safe handling practices. Method Objective/Aims The available evidence supporting the development of home- Development of Australian Consensus Guidelines for safe based chemotherapy programs was reviewed. In addition, handling and administration of MABs for cancer treatment key recommendations which particularly related to consumer by healthcare personnel. Development of a guideline expectations, gaps in service delivery and the strategic implementation package, including organisation readiness direction of cancer services, from WA Health’s Cancer Services tool and e-learning modules, to assist healthcare services with implementation of guideline recommendations. A business model was determined and the service was Method successfully established. It has since achieved ACHS A rigorous methodological approach including critical appraisal accreditation and continues with ongoing assessments and of available evidence, survey of current practice, and formal 50 cancer nursing: leading in a time of change poster abstracts
consensus meetings was undertaken in the development of Results the guidelines. Guidelines were developed in accordance Data collection and analysis is in progress. Preliminary analysis with principles outlined by the National Health and Medical Research Council and led by a multidisciplinary guideline written group with strategic oversight from a steering committee 15.22). including clinical and operational experts. The implementation Males 516 (52%) compared to females 447 (48%). package will be developed based on needs assessed during Admission: 957(96%) compared to Discharged: 30 (3%) Admitted to ward: 922 (93%) pilot phase, followed by public dissemination. Admit to critical care area: 34 (3%) Results Transfer to another hospital: 4 (0.4%) The developed guidelines include seven recommendations: Died in ED: 3 (0.27%) 1) appropriate determinants for evaluating occupational Triage Category 3 or 4: 598(61%) exposure risk; 2) occupational risk level compared with other Conclusions The majority of patients that present to the ED require based on healthcare personnel factors; 4) waste products; admission. Understanding the characteristics of why adult 5) interventions and safeguards; 6) operational and clinical oncology patients require urgent care helps us to develop new factors; and 7) handling recommendations. The implementation models of care that will improve patient outcomes and reduce package is currently under development and due to for pressure on the ED. completion by mid-2014 (in line with CNSA conference). Conclusions 18. PROFESSIONAL CHALLENGES AND The developed guidelines evidence-based directives for the SUPPORT MECHANISMS FOR BREAST safe handling of MABs across a variety of clinical settings. CARE NURSES IN RURAL AND REMOTE QUEENSLAND. 17. URGENT CARE OF THE ONCOLOGY Pammie Ellem1 PATIENT – ANALYSIS FROM A CROSS 1. Central Queensland University, Bundaberg, QLD, Australia SECTIONAL STUDY OF THE CLINICAL Breast Care Nurses (BCNs) have been increasingly employed CHARACTERISTICS OF ONCOLOGY PATIENTS to coordinate and provide ongoing psychosocial support to PRESENTING TO ONE SYDNEY TERTIARY women with breast cancer and their families (Rogers-Clark, REFERRAL EMERGENCY DEPARTMENT 2002). As with other specialities becoming established, issues Meredith Oatley1, Lesley Mullens1, Margaret Fry1 are now arising in relation to professional support, education 1. Royal North Shore Hospital, St Leonards, NSW, Australia and networking for BCNs who anecdotally report that they work alone and feel isolated, particularly those working in rural Introduction areas. The study analysed the trends and characterises of adult oncology patients presenting emergency department (ED). This paper presents the literature review of a study in progress The demand on Australian EDs has increased 4.2% each that is using Participatory Action Research (PAR) as a method year between 2007-2008 and 2011-2012. At the same time for both the study and providing a model of professional the cancer rate has doubled in size since 1991. According development for BCNs in rural Queensland. to Australian Institute of Health and Welfare many oncology According to Reason and Bradbury (2008) PAR seeks to patients present to EDs rather than seeking treatment at alternative healthcare services. To develop new models of care community. It is evident from the literature review that while that better manage oncology patients, we need to explore the BCNs are valued, and there have been some moves to better reasons for ED presentations. support BCNs, much needs to be done in this space. This Aims paper will also provide an overview of how PAR has been The aim of this study was to explore adult medical oncology used to support professional development previously and patient presentations to one tertiary referral hospital. why this may provide a realistic model for BCNs professional development into the future. Methodology was conducted of ED oncology patient presentations. A It is intended that the model of support will be transferable to random sample was then selected of adult oncology patients different cancer modalities and geographic regions. (n=286) admitted to the hospital for analysis.
51 17th winter congress poster abstracts
19. A TABLET A DAY? INTRODUCING A 20. IPILIMUMAB: THE IMPORTANCE OF MOBILE ELECTRONIC DEVICE INTO HOME NURSING EDUCATION AND PATIENT BASED CANCER CARE. ASSESSMENT Robyn Wilson1 Theresa Nielsen1, Lydia Visintin1, Catriona McNeil2 1. Healthcare at Home Australia, Melbourne, VIC, Australia 1. Royal Prince Alfred Hospital, Camperdown, NSW, Australia Introduction Healthcare at Home (HaH) is a specialist home nursing service Introduction which provides complex care for people in their homes, In August 2013, the monoclonal antibody Ipilimumab was workplaces or school settings, including cancer treatment and approved for PBS in the treatment of Stage IV Melanoma. support. Ipilimumab targets cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), blocking a negative regulatory signal in T-cell It is paramount for cancer nurses to be able to conduct a function, which in turn results in T-cell activation and an anti- comprehensive patient assessment at each home visit and tumour immune response. The side effects of Ipilimumab are immune related, so early recognition, assessment and oncologist, and the nurse who delivers the next episode of intervention are pivotal in the care of patients. care. Objectives/Aims Objectives/Aims Adverse reactions to Ipilimumab can range from mild to potentially life threatening, therefore educating patients, carers patient care between the treating nurse, the consultant and the HaH team. The aim of this project was to provide Clinical Nurse Consultant Description/Methodology (CNC)-lead written and oral education to patients, families and A comprehensive validated assessment tool was developed medical registrars. incorporating internationally recognised grading systems. The Description/Methodology assessment tool was formatted to be completed on a tablet Patients commenced on treatment with PBS-funded device by the nurse during a home visit. Nurses were trained in the use of the tablet, the client management system and provided with written and verbal education prior to treatment the assessment tool and the process was measured over a 4 commencement and follow-up telephone support. Post month period. commencement CNC support interactions, and treatment- Results related admissions were recorded. 100% of patient assessment forms were forwarded to the Results treating oncologist within 24 hours of the patient visit. During the study period 26 patients were registered for 75% of patient assessment forms in the patient history were ipilimumab treatment of which 22 received at least 1 dose. CNC available to nurses at the time of the next visit. The nurses led education was provided to 22 patients. There were 154 reported that the tablet and the format were easy to use post commencement support interactions and 5 admissions to however they would have preferred further training in the use hospital for ipilimumab-related toxicity. There were 8 episodes of the client management system. of ipilimumab-related toxicity. Low-grade toxicities were successfully managed in an outpatient setting through CNC Conclusions The electronic format for the assessment of oncology patients admissions and ED presentations. way of managing patient information. Further training will be Conclusion provided in the future. Through on-going education, assessment and early recognition of side-effects by the patient, carer and staff, potentially life-threatening side-effects of ipilimumab were effectively managed, and hospitalisations avoided. Ongoing nursing education and assessment of patients being treated with Ipilimumab is critical in managing treatment-related toxicities.
52 cancer nursing: leading in a time of change company profiles
Amgen Oncology Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, Hospira ANZ developing, manufacturing and delivering innovative human Hospira is a specialty hospital pharmaceutical company therapeutics. This approach begins by using tools like offering sterile injectable pharmaceuticals, infusion devices advanced human genetics to unravel the complexities of and acute-care pharmaceuticals. Through these highly disease and understand the fundamentals of human biology. specialised products, Hospira ANZ offers unique solutions Amgen focuses on areas of high unmet medical need and to the challenges faced by healthcare professionals in their leverages its biologics manufacturing expertise to strive for solutions that improve health outcomes and dramatically Sydney and Wellington, with manufacturing, research and improve people’s lives. A biotechnology pioneer since 1980, development sites in Mulgrave, Victoria and Adelaide, South Amgen has grown to be the world’s largest independent biotechnology company, has reached millions of patients New Zealand dating back to 1845 when FH Faulding opened a around the world and is developing a pipeline of medicines pharmacy in Adelaide. with breakaway potential. Learn more at www.hospira.com.au. For more information, visit www.amgen.com and follow us on www.twitter.com/amgen.
BMS Bristol-Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. Our medicines are helping millions of patients around the world in Celgene Celgene is a leading biopharmaceutical company engaged in the discovery, development and delivery of innovative therapies such as VIDAZA, REVLIMID and THALOMID which Over the past decade, we have delivered 14 new products to patients with serious diseases. Four of these products are improve the prospects for critically ill patients with cancer and biologic products. Additional biologic compounds – as well other debilitating diseases worldwide. as scores of other investigational medicines – are advancing through the development pipeline. Bristol-Myers Squibb is For further information visit our website www.celgene.com.au recognized as having one of the most productive R&D pipelines in the industry. As a BioPharma leader, we believe what sets us apart is our commitment to helping patients prevail over serious diseases diseases. Generating new ideas and thinking differently are at the heart of everything we do – making a difference in the lives of patients.
53 17th winter congress company profiles
Smiths Medical Roche Smiths Medical is a leading global provider of medical devices Headquartered in Basel, Switzerland, Roche is a leader for hospital, emergency, home and specialist environments. in research-focused healthcare with combined strengths Smiths Medical offers market-leading solutions in the major in pharmaceuticals and diagnostics. Roche is the world’s areas of Anaesthesia, Safety Devices, Medication Delivery, largest biotech company, with truly differentiated medicines Ventilation & Patient Monitoring. in oncology, immunology, infectious diseases, ophthalmology and neuroscience. Roche is also the world leader in in vitro By listening to clinicians Smiths Medical continually provides diagnostics and tissue-based cancer diagnostics, and a the equipment, service and expertise you should expect whilst frontrunner in diabetes management. Roche’s personalised consistently delivering value, safety, quality and performance healthcare strategy aims at providing medicines and Smiths Medical offers some of the most respected and easily diagnostics that enable tangible improvements in the health, recognisable brands: Portex™, Medex™, CADD™,Deltec™, quality of life and survival of patients. Founded in 1896, Roche has been making important contributions to global health for more than a century. Twenty-four medicines developed by Roche are included in the World Health Organisation Model Lists of Essential Medicines, among them antibiotics, antimalarials and chemotherapy. In 2013, Roche invested 8.7 billion Swiss francs in research and development worldwide, including approximately $37 million (AUD) in pharmaceuticals in Australia. Genentech, in the United States, is a wholly owned member of the Roche Group. global provider of medical devices for critical care and surgery Roche is the majority shareholder in Chugai Pharmaceutical, acquired Mayo Healthcare to consolidate its presence in Australia. In addition to the Arrow range of vascular access and More information about Roche is available through cardiovascular imaging products that Mayo already distributes www.roche-australia.com. integrate an expanded portfolio of products providing extended choice for Australian clinicians from a single source. Through professionalism and integrity, it is our passion to become the supplier of choice in each therapy area we support, and to be recognised for our unparalleled standard of education and customer service. Free Phone: 1800 656 059 healthcare leader, focused on patients’ needs. The largest pharmaceutical company in Europe and in emerging markets, production and commercialisation. With the recent acquisition of Australia’s leading nutraceutical is now a horizontally integrated healthcare provider from complementary medicines, through to patented medicines, generics, over the counter medicines, and vaccines. our customers, our employees, and even more importantly to the people who rely daily on our medicines.
54 cancer nursing: leading in a time of change notes
Ipsen CNSA Winter Congress Travel Grant Recipients 2014 Thank you to Ipsen for the ongoing contribution to support CNSA Members to participate in the annual CNSA Winter Congress. Congratulations to the recipients of this years Ipsen CNSA Winter Congress Travel Grant: Louisa Robinson, NSW Peta Young, WA
CNSA would like to acknowledge the generous support offered from organisations to enable participation in Winter Congress. In 2014 the recipients are:
CNSA WA Travel Grant Recipient: Hazel Kompara
Prostate Cancer Foundation of Australia Travel Grant recipients: Louise Saliba, VIC Kristen Scott, NSW David Larkin, ACT
Cancer Council Queensland Travel Grant recipients: Cindy Penney Katrina West Penny Reed
55 17th winter congress notes
56 cancer nursing: leading in a time of change notes
57 17th winter congress notes
58 cancer nursing: leading in a time of change notes
59 17th winter congress notes
60 cancer nursing: leading in a time of change NIOSH, ISOPP and ASHP all advocate consideration of using a closed system transfer device to minimise occupational exposure to hazardous drugs.1,2,3 “ CLOSED SYSTEMS LIMIT THE POTENTIAL FOR GENERATING AEROSOLS AND EXPOSING WORKERS TO SHARPS ” NIOSH, 2004
Guidelines for Cytotoxic Drug Handling Health and Safety Legislation
NIOSH Alert. Preventing Occupational Exposures 2004 Occupational Health and Safety Act 1991 s.16 1991 to Antineoplastic and other Hazardous Drugs in Occupational Health and Safety (Safety 1994 Health Care Settings Standards) Regulations 1994 ISOPP Standards of Practice. Section 7- Special 2007 Occupational Health and Safety Code of 2008 Devices Practice 2008 Part 11 – Storage and Handling ASHP Guidelines on Handling Hazardous Drugs 2006 of Dangerous Goods WorkSafe Victoria. Handling Cytotoxic Drugs in 2003 Health and Safety in Employment Amendment 2002 the Workplace Act 2002 (New Zealand) Queensland Government Department of 2005 Industrial Relations, Queensland Workplace Health and Safety Strategy. Guide for Handling Cytotoxic Drugs and Related Waste Workcover NSW. Cytotoxic Drugs and Related 2008 Waste - Risk Management SHPA Standard of Practice for the Safe handling 2005 of Cytotoxic Drugs in pharmacy department
1. NIOSH Alert, Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings, Department of Health and Human Services, Centres for Disease Control and Prevention, 2004. 2. International Society of Oncology Pharmacy Practitioners ISOPP Standards of Practice, Safe Handling of Cytotoxics, Journal of Oncology Pharmacy Practice, 2007, 13:27. 3. American Society of Health System Pharmacists, ASHP, Guidelines of Handling Hazardous Drugs, American Journal of Health System Pharmacists, 2006: 63: 1172-1193. 4. SHPA Standard of Practice for the Safe handling of Cytotoxic Drugs in Pharmacy Department. J Pharm Pract Res. 2005; 35 : 44-52.
WE LISTEN. WE THINK. WE DISCOVER. WE CREATE. WE ADVOCATE. WE INVEST.
© Hospira Pty Ltd 2014 ABN 13 107 058 328 140508CLAV. May 2014 CONGRESS MANAGERS Chilli Fox Events Pty Ltd Tel: 02 8005 1867 Email: [email protected] Website: www.chillifoxevents.com.au
www.cnsawintercongress.com.au