Oncology/haematology patients use of an acute oncology specialist nursing service to avoid emergency department admission

Abstract

Background / Problem Identified: In 2021 347 new patients were referred to St Therese’s Oncology Day Unit and St Bernadette’s Ward for systemic anti-cancer treatment (SACT). Most of these patients will experience side effects which can be mild, moderate, or severe. In 2020 the National Cancer Control Program (NCCP) funded a 1.0 WTE Acute Oncology Service (AOS) CNS with the primary role of being the first point of contact for patients experiencing SACT side effects. The overall aim of the AOS CNS role is: Provide Telephone Triage to assess and advise Oncology Haematology patients experiencing SACT side effects using the UKONS 24-hour triage tool (a symptom-based oncology assessment tool using NCI-CTTAE (see diagram). Provide a rapid access pathway for Oncology/Haematology patients to address acute side effects from SACT. Ensure patients receive appropriate nursing and medical interventions to avoid Emergency Department attendance and reduce Hospital admissions and length of inpatient stay. An evaluation of the Acute Oncology Service in April 2021 highlighted our patients experiencing side effects from SACT continued to contact St Therese’s Ward, their GP or attend the Emergency Department for advice and management. The advice they received was impromptu and not consistent. Patients continued attending the Emergency Department for medical assessment. The AOS CNS didn’t have a dedicated space to admit patients for review. There was no clear AOS patient pathway. Combined these factors contributed to the underutilization of the Acute Oncology Service from its introduction in August 2020 until review in April 2021.