Author: Ms. Chan Sau Yee
Credentials: RN, MSN, FHKAN (Medicine-Oncology)
Affiliation: Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong
Hospital Authority in Hong Kong has adopted and promoted the primary nursing as the care delivery model since 2003. It aims to facilitate a better organization of nursing care and enhance the autonomy in clinical nursing practice so as to enhance the quality of patient care and increase the professional accountability.
In the Department of Clinical Oncology of Pamela Youde Nethersole Eastern Hospital (PYNEH) of Hong Kong, we applied this nursing care model to two specific groups of cancer patient for the purpose of ensuring the patient safety, better adherence to the clinical management plan and the continuity of care.
These two specific groups of patients were: (1) patients with head and neck cancer underdoing radical non-surgical oncology treatment; and (2) patients suffered from neutropenic sepsis. They were selected because severe toxicities were commonly reported during the late phase of treatment among the former, whereas the latter condition was an oncology emergency and potentially fatal. Both of them required intensive medical and nursing management and support.
The primary nurse introduced herself to a cancer patient.
A Primary Nursing Team was developed and 12 qualified oncology nurses were invited to join. The team was responsible for literature review, developed evidence-based nursing care protocol, related workflow and update of nursing care plan. Training to all ward nurses was provided by the team before implementation including care protocol, special assessment and care to enhance engagement and compliance. Electronic documentation was adopted to serve as a care planning template, facilitate better communication among nurses and easy access of patients’ progress by multidisciplinary team.
It was also integrated with the weekly nursing grand round led by the nurse consultant and senior nurses to enhance the nursing standard and render support.
Compliance audit and documentation review were performed before and 3 months after the start of the program. The overall staff compliance rate increased from 73% to 94% for the Neutropenic Sepsis Team; and from 63% to 87% for the Head and Neck Team.
Moreover, documentation review showed that (i) more than 95% of primary nurses were able to assess and provided specific and effective nursing care to patients with head and neck cancer or neutropenic sepsis, (ii) communication among the ward nurses was enhanced, and (iii) documentation was clearer with more essential details.
Furthermore, the value of this program was recognized by the Nursing Service Department (NSD) of our Hospital. We had shared the logistic, roll out plan and essence of the program with frontline nurses of other Departments in the Primary Nursing Workshop organized by NSD in 2016 and 2017 respectively.
Nursing grand round with the primary nurse in an oncology ward to review the clinical care.
Oncology nursing plays a critical role in ensuring patient safety and providing quality care. The implementation of primary nursing care model was challenging; however, it demonstrated the benefits of provision of personalized nursing care that tailor-made for individual patient’s needs, and increasing the satisfaction for both the patients and nurses.
Author: Yongyi Chen
Affiliations: Hunan Cancer Hospital
As the vice president of Hunan Cancer Hospital (HCH), I feel truly honored to attend the Global Academic Programs (GAP) Conference at Stockholm, Sweden from 15-17 May, 2018. HCH is the 31st Sister institution of MD Anderson Cancer Center (MDACC) worldwide, the 5th in mainland China. MDACC and HCH have conducted in-depth cooperation in training medical personnel, transferring international treatment, disseminating medical techniques, sharing medical solutions, etc.
The GAP Conference this year is held by Karolinska Institutet and Karolinska University Hospital in Stockholm. The institute is famous for the Nobel Committee for annual assessment and award of Nobel Prize in physiology or medicine. The theme of GAP Conference 2018 is “Global efforts fighting cancer”. With the joint goal, the annual GAP Conference offers a platform for faculties from MDACC and its Sister institutions to work collaboratively. Experts and scholars form 38 Sister institutions all over the world attended the conference to discuss the progress on cancer treatment and care. The fundamental research, epidemiology, treatment status and progress of oncology were included and deeply analyzed. The experts put forward a series of methods and measures to improve the diagnosis and treatment of cancer. The participants really get great inspirations.
There were over 600 abstract submissions, 16 simultaneous sessions, 155 oral presentations at the conference. Among them, 7 oral presentations and over 20 poster presentations from HCH ware accepted. I delivered an oral presentation “Life satisfaction of cancer patients: what contributes to a better satisfaction with life” at the Nursing Program. Our academic reports were acclaimed by other colleagues from all over the world, which laid a solid cooperative foundation for scientific research.
China Cancer Society Cancer Conference was held from August 17-20, 2018 in Shenyang, Liaoning.
President of the International Association of Oncology Care, Professor Patsy Yates of the Department of Nursing, Queensland University of Technology, Australia, brought a greeting from the International Association of Cancer Care Nurses to Chinese nurses. At the same time, she put forward the important point of the current status of pulse oncology care: nurses should carry out role transformation and provide personalized cancer treatments. Today’s cancer treatment is becoming more and more precise, and the development of technology provides a new approach to care, and nurses play a key role in ensuring the best outcomes and experiences of patients. Nurses should understand the impact of the experiences on patients, customize interventions for patients, and support patients’ self-management.
Then, Professor Kim Alexander of the Department of Nursing at the Queensland University of Technology in Australia gave a detailed explanation of this point, detailing the new approach to cancer care research – personalized symptom care. He exemplified “new measures on understanding experiences” and “new measures on test interventions”. New measures to opening a new way of thinking about cancer care. Bring together wisdom thinking, stimulate innovation vitality, enhance the connotation of disciplines, and improve the level of discipline construction.
Professor Brenda Marion Nevidjon, CEO of the American Society of Cancer Nursing, conducted an exchange on the study of the tolerant behavior of cancer nurses. The professor took the rapid changes in the cancer care industry as an entry point to deeply analyze the psychological state of cancer nurses, from three aspects: thought, behavior, and performance. Provide guidance to nurses working on cancer: strengthen self-cultivation, improve work resilience, and serve human health.
Professor Anne Fitzgerald and Prof. Margaret Hjorth from ICON Medical Group of Australia shared the Australian cancer care model with participants from the three aspects of cancer patient assessment and program development, oncology nursing professional ability training and safety skills training.
Through learning exchanges, Chinese oncology nurses have been enlightened to learn advanced cancer care knowledge and technology to improve the level of cancer care.
Prof. Harue Arao
Osaka University Graduate School of Medicine
Asian Oncology Nursing Society(AONS)の第2回目となるカンファレンスが、2015年11月19 日～ 21 日に韓国において盛大に開催されました。
Ferrans博士のQuality of Life of Cancer Patients: Value in Clinical careの講演は、看護の視点から、Patient centered QOL を捉えたものであり、博士らが開発された尺度の紹介がありました。尺度は、英語以外の言語に翻訳するプロジェクトが数ヶ国で進んでいました。今後さらに注目を浴びることでしょう。
by Anisur Rahman Forazy, Begum Rabeya Khatun Chowdhury Nursing College, Sylhet, Bangladesh.
Breast cancer remains the most common cancer among women in Bangladesh. It has become a hidden burden which accounts for 69% of cancer death in women1. In Bangladesh, the incidence rate of breast cancer was about 22.5 per 100000 in females2; Breast cancer has been reported as the highest prevalence rate (19.3 per 100,000) among Bangladeshi women between 15 and 44 years of age when compared to other types of cancer. Cervical cancer ranked second for this group of women, with a prevalence rate of 12.4 per 100,000 in 2008-2010. An increase in incidence rate has been reported due to lack of disease awareness, lack of confidence about medical treatment, improper screening tests and maltreatment of early metastasis3.
Furthermore, patients are kept away from cancer treatment due to poor socio-economic infrastructure, social stigma of the disease and fear of the cancer treatment. The results of the maternal mortality survey conducted by the National Institute of Cancer Research and Hospital in Bangladesh (2010) showed that 21% of total number of death among women between 15 and 49 years of age was due to breast cancer.
Apparently, breast cancer is becoming a major public health concern of the Bangladesh government, which is evidenced by the establishment of the National Institute of Cancer & Research Hospital, Bangladesh. A study conducted in the northern part of Bangladesh named Khulna Division in 2007 – 2008 showed that 87% of new cases of breast cancer were diagnosed as stage III+, where cancer has spread to other parts of the body. The treatment options were limited and very expensive, especially in a low-resource country such as Bangladesh. The main possible reason is lack of public awareness for early detection of cancer, which reflects the actual situation in rural areas of Bangladesh.
Qualified specialty nurses are important as they play a vital role of providing holistic care to patients with cancer. Therefore, there is a strong need of developing a crash programme to prepare competent nurses, who should have knowledge of prevention and early detection of cancer, how to develop and implement an effective care plan, and counselling techniques. As we know, breast cancer in particular, can be treated effectively if detected early. Therefore, there is an urgent need of preparing Bangladesh nurses to take care of cancer patients as well as take part in cancer prevention and early detection of cancer.
- International Agency for Research on Cancer (2008). GLOBOCAN 2008: Cancer Incidence and Mortality Worldwide. http://www.iarc.fr/en/media-centre/iarcnews/2010/globocan2008.php
- Uddin A.F., Khan Z.J., Islam J., & Mahmud, A. (2013). Cancer care scenario in Bangladesh. South Asian Journal of Cancer, 2(2), 102-4.
- Editor (2013, October 9). Feature, Femina. The Daily Star.