As an ESMO designated centre of integrated oncology and palliative care it is important to have a range of skill mix and experience across the oncology nursing staff caring for these patients. Within a large acute general hospital, with patients on various wards across the hospital, challenges in achieving these aims may present themselves. The core ward consists of 14 single rooms; the non-core wards have a mix of 1, 2, 4 and 6 bedded rooms. This analysis aimed to assess the nature of hospitalisations and the associated outcomes for the whole cohort of patients on the associated ward.
All inpatients who were admitted or were pre-existing patients during the period of 8 weeks of analysis were assessed. The main features considered were the age, gender, cancer diagnosis, co-morbidities, reason for admission, and whether they returned to home, hospice or died in hospital. Whether patients were on the core chemotherapy ward or on outlying wards was assessed. Data from retrieved from the medical and nursing handover records and clinical information system of the Hospital.
There were 44 patients (37.8%) cared for over the 50 admissions on the Core Therapeutic Ward staffed by oncology nurses over the 8 week period with the remainder cared for over the 92 admissions on outlying wards staffed by non-oncology nurses. The three most common reasons for admission (core/non-core ward) included symptom management with disease progression (42% vs 50%), anti-cancer therapy associated toxicities (18% vs 13%) & decline in activities of daily living (16% vs 15%). The most common oncology primary cancers included CNS (25% vs 20%), Lower GI (16% vs 15%) and GU (11.4% vs 13.5%). Disease related impaired cognition was the most common baseline co-morbidity present in each cohort (27.3%/12.2%). The patient discharge outcomes on each ward (onc/non-onc) were home (56.8%/85.1%), rehabilitation or long term care (10.1% vs 2.7%), hospice (6.8%/4.1%) and death (27.3%/8.1%) reflecting that less well patients tended to be cared for within the specialist ward.
Balancing the optimal location and nursing skill set is a challenge and remains an important focus and priority within a service ranging from high dose chemotherapy administration for curative intent to palliative and terminal care.
Clinical trial identification
Legal entity responsible for the study
Beaumont Hospital Cancer Centre.
Has not received any funding.
All authors have declared no conflicts of interest.