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S. Wakelin



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    MA 08 - Supportive Care and Communication (ID 669)

    • Event: WCLC 2017
    • Type: Mini Oral
    • Track: Nursing/Palliative Care/Ethics
    • Presentations: 1
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      MA 08.01 - Incorporating the Review of Patients on Immunotherapy into an Established Lung CNS Nurse Led Review Clinic (ID 7479)

      11:00 - 12:30  |  Author(s): S. Wakelin

      • Abstract
      • Presentation
      • Slides

      Background:
      The Kent Oncology Centre has been instrumental and innovative in the development of nurse-led services since 2005. The Lung CNS’s have been conducting oncology clinics since 2009 reviewing patients on TKI’s and chemotherapy. With Immunotherapy now available to some lung cancer patients, the Lung CNS's needed to incorporate immunotherapy review into their established clinics. The Lung CNS's worked collaboratively to develop a patient-centred electronic assessment tool. The tool would ensure standardised practise, patient safety and assess toxicities whilst on Immunotherapy. The aim is for the Lung CNS’s to utilise the electronic tool and roll out through an educational programme thus increasing knowledge and confidence and empowering nurses to safely review patients on immunotherapy.

      Method:
      To incorporate immunotherapy patients to an established CNS Nurse-led review clinic: Agreement between Consultant and Senior Nurses. Discussions with Computer Sciences, Lung Cns's, Oncologists, Chemotherapy Lead Nurse. Educational Requirements - Consultation and Physical Examination Skills, Non-Medical Prescribing, Chemotherapy Competence, IRMER. Protocols - Agreed for the Nurse Led Oncology review clinic. Competence - The Lung CNS requires a set of practice and competence in judgement and decision making. How the clinic works Consent by the consultant. Consultant toxicity assessment pre cycle 2. Reviewed thereafter by lung CNS or Chemotherapy Nurse prior to each treatment. Electronic Toxicity assessment completed. Weight/Observations recorded. Bloods FBC, U&E's, LFT's. Thyroid 8 weekly. 9am cortisol LH and FSH Direct access to consultant. Consultant review with CT scan.

      Result:
      Figure 1 Reported Toxicities. Adisonian Crisis Hypothyroidism Diarrhoea/Colitis Fatigue Hepatitis Skin Reactions Pneumonitis



      Conclusion:
      The number of patients on Immunotherapy treatment is set to rise. Incorporating the review of Immunotherapy into an established Lung CNS Nurse-led Review clinic enabled standardised practise, enhanced patient safety and provided continuity of care. Through education and training and by using an electronic assessment tool; chemotherapy nurses can be empowered to review patients on Immunotherapy.

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