Wednesday 3rd April 2013
Team Leader Hannah Pritchard describes how the Macmillan Acute Oncology Service in Southampton is helping people in an emergency.
The Macmillan Acute Oncology Service provides people with reassurance, urgent treatment and specialist advice, without needing to attend the emergency department. It was set up more than 18 months ago with funding from Macmillan. The team includes two band 6 nurses working in the area between 8am and 8pm each day, and a specialised registrar working within core hours.
The service takes referrals from a 24-hour advice line and from surrounding clinics, clinical nurse specialists, research nurses and consultants. We have two chair spaces and two beds where patients are reviewed and assessed. We review people with a variety of cancer-related emergencies, from pain management to neutropenic sepsis.
Patients are seen immediately by a nurse, where emergency treatment begins. We have patient group directives in place for medicines such as tazocin (a first-line antibiotic used in neutropenic sepsis) and clexane (an anti-coagulant). This helps us to provide timely treatment, reducing complications and preventable deaths.
The advice line is held by the acute oncology team between 8am and 8pm and by the cancer care wards overnight. We use the UK Oncology Nursing Society (UKONS) triage protocols to assist us with the management of these calls. The phone has become a crucial asset to people undergoing treatment for cancer, with a clinical audit showing that the number of calls has tripled since the service was established. We have had extremely positive feedback from patients using the advice line, referring to it as their ‘lifeline’.
As part of our service we also undertake an ‘outreach’ service, where we visit patients who are known to have a cancer diagnosis but are admitted to non-cancer care wards. This ensures that specialist advice is provided and that patients are on appropriate pathways.
We have gathered a large amount of data since the service began. In the first six months we identified that a large volume of calls were from people suffering with nausea and vomiting as a consequence of treatment for breast cancer. Research was carried out to explore this further and it was found that people having treatment for breast cancer were suffering most with this preventable complication. The hospital has now agreed that all women undergoing treatment for breast cancer should receive an NK1 receptor antagonist (a type of anti-emetic). Since this has been incorporated into their regimen, there has been a significant reduction of this unpleasant side effect. This research was taken to the Multinational Association of Supportive Care in Cancer in New York last year.
Our service was also represented at the International Conference on Cancer Nursing in Prague, where two of our practitioners presented to many international delegates. It was inspiring for us all to attend these conferences with such a range of health professionals, and to learn and share with them ways in which we can develop our service.
We are passionate and dedicated to improving the lives and experiences of people affected by cancer, and we strive for a service that places the patient at the heart of everything we do.
Hannah Pritchard, Team Leader, Macmillan Acute Oncology Service,University Hospital Southampton NHS Foundation Trust.