The reasons that cancer patients who are receiving systemic anti-cancer therapy make unplanned ED presentations are more complex than you might think.
30 September 2020
Lecturer in Cancer Nursing, PhD Candidate, SURC Clinical Nurse Consultant
University of Melbourne and the Olivia Newton-John Cancer Research and Wellness Centre
One in ten people with early stage cancer, and up to 45% of people with advanced cancer will receive systemic anti-cancer therapy (SACT). The administration of SACT in the inpatient setting is costly and is often reserved for patients who require frequent monitoring. Subsequently, the majority of SACT is delivered in the outpatient setting. However, it is estimated that as many as 80% of people who receive SACT in routine care will develop treatment related side-effects. Side-effects may be mild and easily self-managed at home, or they may be severe, warranting urgent medical assessment and care.
Emergency department (ED) presentations are common for people with cancer, with recipients of SACT known to have an increased likelihood of ED presentation. The need to deliver safe, efficient, and reliable care to cancer patients who receive SACT in the outpatient setting has been recognised locally and internationally, with a variety of strategies identified to mitigate the need for unplanned ED presentations. The incidence of unplanned ED presentations in this cohort is reported at between 6% and 83% of patients. The high degree of variance is likely due to the heterogeneity of published literature in both methodology and reporting.
This presentation will describe the methodological heterogeneity and clinical diversity of studies reporting on unplanned ED presentations made by cancer patients receiving SACT, as well as the preliminary results of a series of qualitative interviews about why this cohort of patients might make an unplanned ED presentation after receiving SACT.
Polly Dufton is a Registered Nurse who currently works as a Clinical Nurse Consultant in the Symptom and Urgent Review Clinic at the Olivia Newton-John Cancer Research and Wellness Centre. Polly has worked in both the haematology, and blood and marrow transplant setting, as well as in the medical oncology setting.
Polly holds the position of Lecturer in Cancer Nursing at the University of Melbourne, where she is also completing her PhD exploring unplanned Emergency Department presentations in cancer patients receiving SACT. Polly is the Course Coordinator for the Graduate Certificate in Cancer Nursing at the University of Melbourne, where she also teaches cancer nursing practice, and evidence-based practice.
Polly has a passion for evidence-based practice and helping nurses develop practical skills to locate, implement and evaluate evidence in the clinical setting.