oncology ward
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2021 ◽  
Author(s):  
Bethany A. Van Dort ◽  
Melissa T Baysari ◽  
Mirela Prgomet ◽  
Wu Yi Zheng ◽  
Magdalena Z Raban ◽  
...  

Electronic medication management (eMM) systems can have a significant impact on efficiency and safety. There is limited evidence on the effects of eMM implementation on the physical location of work. The objective of this study was to evaluate the impact of eMM and associated hardware implementation on the location of tasks performed by doctors and nurses. 41.5 hours of observation were conducted in the oncology ward of a paediatric hospital. Tasks, locations and resources used were recorded pre and post eMM implementation. Results showed that a wider variety of locations were used to conduct tasks following eMM implementation. Post-eMM, more tasks were performed in the hallway, where medication trolleys with attached laptops were situated, and in patient rooms where additional computers were installed, providing more opportunities for patient/carer and clinician interaction. The findings from this study reveal the impact that computer placement has on the location of work for doctors and nurses, and the importance of planning hardware placement for eMM implementation.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Mills ◽  
Alexis Schmid ◽  
Mohammad Najajreh ◽  
Ahmad Al Nasser ◽  
Yara Awwad ◽  
...  

Abstract Background Pediatric Early Warning Scores (PEWS) are nurse-administered clinical assessment tools utilizing vital signs and patient signs and symptoms to screen for patients at risk for clinical deterioration.1–3 When utilizing a PEWS system, which consists of an escalation algorithm to alert physicians of high risk patients requiring a bedside evaluation and assessment, studies have demonstrated that PEWS systems can decrease pediatric intensive care (PICU) utilization, in-hospital cardiac arrests, and overall decreased mortality in high income settings. Yet, many hospital based settings in low and lower middle income countries (LMIC) lack systems in place for early identification of patients at risk for clinical deterioration. Methods A contextually adapted 16-h pediatric resuscitation program included training of a PEWS tool followed by implementation and integration of a PEWS system in a pediatric hematology/oncology ward in Beit Jala, Palestine. Four PDSA cycles were implemented post-implementation to improve uptake and scoring of PEWS which included PEWS tool integration into an existing electronic medical record (EMR), escalation algorithm and job aid implementation, data audits and ward feedback. Results Frequency of complete PEWS vital sign documentation reached a mean of 89.9%. The frequency and accuracy of PEWS scores steadily increased during the post-implementation period, consistently above 89% in both categories starting from data audit four and continuing thereafter. Accuracy of PEWS scoring was unable to be assessed during week 1 and 2 of data audits due to challenges with PEWS integration into the existing EMR (PDSA cycle 1) which were resolved by the 3rd week of data auditing (PDSA cycle 2). Conclusions Implementation of a PEWS scoring tool in an LMIC pediatric oncology inpatient unit is feasible and can improve frequency of vital sign collection and generate accurate PEWS scores. Contribution to the literature This study demonstrates how to effectively implement a PEWS scoring tool into an LMIC clinical setting. This study demonstrates how to utilize a robust feedback mechanism to ensure a quality program uptake. This study demonstrates an effective international partnership model that other institutions may utilize for implementation science.


BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ruo Han Ma ◽  
Xue Ping Zhao ◽  
Zhi Hong Ni ◽  
Xiao Ling Xue

Abstract Background Considering cancer death is second only to accidental death in the number of lives claimed each year,nurses in paediatric oncology wards often experience helplessness, sadness, frustration and such other adverse emotions when they witness children’s death due to cancer.However,there is a lack of qualitative studies on nurses who witness the death of children in paediatric oncology wards in China. Method A qualitative study was conducted using a semi-structured interview guide with 22 paediatric oncology ward nurses. Interviews were recorded and simultaneously translated and transcribed. Thematic analysis was used to analyse the data. Results The analysis resulted in the identification of three main thematic categories: Different emotional expression, Different copingstrategies, A weak support system. Nursing managers should pay attention to problems faced by nurses in paediatric oncology wards, and take targeted measures in terms of continuing training courses, improving the psychological adaptability of oncology professional nurses, and providing them substantive support. Conclusion Nurses in paediatric oncology wards have strong stress responses to facing the death of children. They reported experiencing complex psychological feelings and have different coping attitudes. Healthcare authorities should recognise and understand the needs of paediatric oncology ward nurses, who often witness the death of children. Appropriate and effective support measures should be planned and implemented for these nurses to maintain their mental health, thus enabling them to better serve patients.


2021 ◽  
Vol 38 (6) ◽  
pp. 385-398
Author(s):  
Fatemeh Ebrahimpour ◽  
Jila Mirlashari ◽  
Akram Sadat Sadat Hosseini ◽  
Fariba Zarani ◽  
Sally Thorne

Background Hope nurtures confidence and enhances positivity. It is known to be a critical factor in illness, recovery and healing. This study aimed to identify the views of hospitalized children with cancer about the circumstances and factors that create hope for them in the oncology ward. Methods: This qualitative study explored children's experiences using Photovoice, which is an arts-based approach. Twenty children aged 6–12 years diagnosed with various cancers at a Pediatric Hospital in Tehran, Iran, participated in this study. Participants were requested to take photographs of objects, circumstances, or anything that gave them hope or represented a sign of hope in the oncology ward. The photographs were then used to facilitate face-to-face interviews with these children. Data were analyzed using thematic analysis. Results: Data analysis revealed six main themes: emotional connectedness with nursing staff; the playroom as a means to soften the hospital space; the presence of a parent; symbols of recovery; a touch of nature in the hospital setting; and escaping the hospital cage. Discussion: Hopefulness among children can emanate from diverse events and circumstances within the hospital environment. Nurses and physicians need an understanding of children's perspectives to design interventions to improve hopefulness among hospitalized children with cancer.


2021 ◽  
pp. bmjspcare-2021-003138
Author(s):  
Gwenyth Day ◽  
Danielle Bear ◽  
Marilyn Swinton ◽  
Daniel Karlin ◽  
Peter Phung ◽  
...  

ObjectivesAlthough death is not uncommon for hospitalised patients with cancer, there are few interventions in oncology that are designed to create a dignified, compassionate end-of-life (EOL) experience for patients and families. The 3 Wishes Project (3WP), a programme in which clinicians elicit and implement final wishes for dying patients, has been shown effective in intensive care units (ICUs) at improving the EOL experience. The objective was to initiate 3WP on an oncology ward and evaluate its effect on family member experiences of their loved one’s EOL. We hypothesised that the 3WP can be implemented in the non-ICU setting and help oncological patients and their families with transition to the EOL.MethodsWhen the patient’s probability of dying is greater than 95%, patients and families were invited to participate in the 3WP. Wishes were elicited, implemented and categorised. Audiorecorded, semistructured interviews were conducted with family members, transcribed and analysed using content analysis.Results175 wishes were implemented for 52 patients with cancer (average cost of US$34). The most common wish (66%) was to personalise the environment. Qualitative analysis of 11 family member interviews revealed that the 3WP facilitates three transitions at the EOL: (1) the transition from multiple admissions to the final admission, (2) the transition of a predominantly caregiver role to a family member role and (3) the transition from a focus on the present to a focus on legacy.ConclusionThe 3WP can be implemented on the oncology ward and enhance the EOL experience for hospitalised patients with cancer.


Author(s):  
Loghman Ghaderi ◽  
Ali Reza Naseri

Background: Chemotherapy-induced neutropenia is one of the risk factors for infection in patients undergoing chemotherapy (due to the weakened immune system). Febrile neutropenia (FN) may be the sole indicator of an underlying infection in these patients. Objectives: Since infection is associated with an increased risk of mortality in patients undergoing chemotherapy, the present study aimed to assess the incidence of FN in neutropenic cancer patients admitted to an oncology ward. Methods: This retrospective, descriptive, and cross-sectional study was conducted on 52 patients (selected using the census method) with signs of infection (i.e., FN) hospitalized in Ghazi Tabatabai Hospital in Tabriz, Iran, within 2018 - 2020. The data were collected by a researchermade form and analyzed using descriptive statistics (e.g., frequency, percentage, and mean) and chi-square in SPSS software (version 20). The significance level was considered less than 0.05 Results: The absolute neutrophil count was less than 500 cells/ml in 15.38% of the patients (n = 8). Infection was the cause of FN in 69.23% of the subjects (n = 36). An unknown factor was the cause of infection in 30.77% of the cases. The incidence of all types of infections (i.e., perianal abscess, sepsis, oral infection, cutaneous infection, gastrointestinal infection, pharyngitis, pneumonia, and urinary tract infection) was higher in patients undergoing chemotherapy than that reported for those not receiving chemotherapy. Conclusions: The results of this study suggested that cancer patients undergoing chemotherapy should be aware of infection signs; accordingly, they can visit treatment centers in case of the first symptoms of infection to prevent progression of infection and reduce mortality rates.  


2021 ◽  
Author(s):  
Ruo Han Ma ◽  
Xue Ping Zhao ◽  
Zhi Hong Ni ◽  
Xiao Ling Xue

Abstract Background: Considering cancer death is second only to accidental death in the number of lives claimed each year,nurses in paediatric oncology wards often experience helplessness, sadness, frustration and such other adverse emotions when they witness children’s death due to cancer.However,there is a lack of qualitative studies on nurses who witness the death of children in paediatric oncology wards in China. Method: Semi-structured interviews were conducted with nurses in the paediatric oncology wards at three children’s hospitals in Jiangsu,China,between January and June 2019.A total of 22 paediatric oncology ward nurses (18 female and 4male) aged between 26 and 39 years were enrolled. A previously developed and pilot-tested interview guide was used for the interviews. The number of interviews was determined by data saturation.Results: Nurses in paediatric oncology wards have strong stress responses to facing the death of children. They reported experiencing complex psychological feelings and have different coping attitudes. Nursing managers should pay attention to problems faced by nurses in paediatric oncology wards, and take targeted measures in terms of continuing training courses, improving the psychological adaptability of oncology professional nurses, and providing them substantive support.Conclusion: The findings of this study increase the knowledge and understanding regarding a seldom-studied topic in China. Healthcare authorities should recognise and understand the needs of paediatric oncology ward nurses,who often witness the death of children.Appropriate and effective support measures should be planned and implemented for these nurses to maintain their mental health, thus enabling them to better serve patients.


2021 ◽  
Author(s):  
Matteo Amicucci ◽  
Federica Perigli ◽  
Giuliana D'Elpidio ◽  
Adele Ripà ◽  
Angela Mastronuzzi ◽  
...  
Keyword(s):  

2021 ◽  
Vol 12 (4) ◽  
pp. 76-80
Author(s):  
Shadma Yaqoob ◽  
Areena Hoda Siddiqui ◽  
Sunil Sharad Dabadghao

Background: Hospital acquired infection (HAI) or Nosocomial Infection (NI) is a well-known entity among patients. The onco-hemological patients are immune-compromised and are at high risk of acquiring these infections. Routine screening of these patients for the presence of micro-organisms, their identification and sensitivity at the time of admission, and during stay, can help us in identifying infections and guiding therapy. Aims and Objective: This study was undertaken to find out the role of routine screening of admitted patients in oncology ward with empirical therapy during neutropenic episodes. Nosocomial Infection Screening (NIS) test was performed for these patients. This test was done to detect Methicillin Resistant Staphylococcus Aureus (MRSA) and Extended Spectrum Beta Lactamases (ESBL) producing Gram Negatives. The NIS results obtained were correlated with organisms isolated from blood cultures. Material and Methods: This retrospective study was done from period of May, 2013 to February,2017 in patients of oncology ward. Only those patients whose NIS test and blood culture was sent to the lab were included in the study. Result: A Total number of 52 NIS tests and blood cultures were included in the study. Among 28 positive NIS samples, 19 samples correlated with blood cultures. Among 24 negative NIS sample 17 correlated with blood cultures. The p value was 0.017, PPV 73%, NPV 64%. SPSS software was used to calculated values. Conclusion: This study showed that NIS test can be used as a tool for predictive marker for septic episodes in these patients.There is a higher probability of developing septic episodes with positive NISsamples.At the same time negative NIS result does not rule out infection.


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