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Andrea Byatte



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    P3.07 - Nursing and Allied Professionals (Not CME Accredited Session) (ID 973)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.07-03 - Lung Cancer Clinical Nurse Specialist & Palliative Care Nurse Specialist – A Dual Role (ID 11803)

      12:00 - 13:30  |  Author(s): Andrea Byatte

      • Abstract
      • Slides

      Background

      The majority of Lung cancer diagnoses are advanced at presentation. There have been advances in treatment over the last 5 years, with new therapies developed enabling improved prognosis for palliative patients. In the UK, just 20% of Stage 4 NSCLC will survive to one year. (CRUK2018). At East Cheshire in 2017, 66.1% of patients were non-curative on diagnosis, of these 42% were referred directly to specialist palliative care (SPC).

      Ferrel et al (2015) reported significant improvements in QOL, symptoms, and reduced distress for palliative NSCLC patients. While El et al (2014) suggested that palliative care providers need to become front-line team members, who provide a high-quality service in order to facilitate early integration of palliative care.

      At East Cheshire NHS Trust, England, the Lung Cancer CNS has a dual role as Community SPC nurse. This ensures patients are supported from pre-diagnosis through treatment, living with and beyond, then onto end of life care with the same keyworker.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The Lung CNS is present in clinic pre-diagnosis and at MDT when management plans are formulated. Patients who are referred directly for SPC due to frailty or co-morbidities that exclude them from anti-cancer treatment are allocated a key worker/CNS. The CNS is present when bad news is broken to the patient and carers. They co-ordinate all services required for the patient and arrange follow up: either hospital inpatient review, a further nurse-led clinic appointment or a home visit. The CNS will discuss and organise advanced care planning ensuring patient wishes are met.

      4c3880bb027f159e801041b1021e88e8 Result

      This model of working has been evaluated with excellent feedback.

      Carer response has been very positive: a patient’s wife said “thank you for being there when we heard the bad news and for being there at end of life. Having one person who knew the journey throughout has been very reassuring.”

      Another patient’s daughter stated “having the guidance of the CNS from diagnosis to death, for my father was invaluable in ensuring his wishes were fulfilled.

      The Commissioners of Quality Care (CQC) in January 2018 rated care at the end of life in the community as outstanding.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The service at East Cheshire offers a novel model of working for patients and carers. The same key worker being present throughout has a positive impact on their lives. Further research is required to fully understand the impact of the role on the quality of life and especially on prognosis.

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