The Director of the National Cancer Control Programme has congratulated the Donegal Public Health Nurses who have become the first nursing group to graduate from the new Community Oncology Education Programme.
The nurses will become the first nurses nationally to deliver a specific range of cancer services to patients in their own homes.
Acknowledging the important role of nurses in the delivery of cancer services, Dr Susan O’Reilly said she was impressed by the depth of knowledge and experience of oncology nurses in Ireland – drawing comparisons with international experience and noting that Irish nurses were on a par with the best in the world.
Expressing her delight in making her first formal visit to the NCCP satellite cancer unit in Letterkenny, Dr O’Reilly stressed the important link between the designated cancer centres and the communities they serve.
For the NCCP, this new community oncology education programme is a key component in the development of cancer services in the community.
According to Dr Marie Laffoy, Community Oncology Advisor with the NCCP – “We know that most patients, where possible, prefer to receive treatment at home. Where it is safe and appropriate for this to occur we are working to make that happen.
“A major objective of the HSE is to integrate health care between the community and hospital services. HSE structures have been reconfigured in an effort to achieve this priority. This way of working will enable the best possible coordination of patient care, whereby all health personnel who treat a patient, work together to ensure the best possible patent outcome.
“It is a priority for the HSE to maximise its available resources to the advantage of patient care and outcomes. This includes the conversion of inpatient work to day case work; a focus on reducing patient length of stay in acute hospitals; the implementation of hospital avoidance strategies and the provision of more services in community settings thus reducing the dependency on inpatient beds.”
The NCCP is working in partnership with the HSE Office for Nursing and Midwifery Services, acute hospitals, primary care and community care settings to deliver a safe and seamless medical oncology service to adult oncology patients. Some oncology patient care can be safely provided in the community setting.
Dr Laffoy added: “The Community Oncology Nursing Programme is an excellent example of how patient care can be integrated between hospital specialist services and community health services. It aims to promote best practice in caring for cancer patients in the community.”
It further aims to ensure that service delivery is seamless, that legislative and regulatory requirements are met and that employees and line managers understand their roles and responsibilities.
It intends to facilitate effective nurse education and training to ensure competency, act as educational tool and further act as a basis for audit and evaluation. The service can be delivered by community nurses who have successfully completed the NCCP Community Oncology Education Programme.
Dr Laffoy concluded: “In choosing Letterkenny as the pilot site we knew we had the skills and experience of individuals like Janice Richmond (Advanced Nurse Practitioner, LGH) Dr Karen Duffy (Consultant Medical Oncologist) Dr Anne Flood (Director of Nursing LGH) Eileen Quinn (Director of Public Health Nursing, Donegal) who along with the support of management including Sean Murphy (General Manager LGH) and John Hayes (Local Health Manager) successfully collaborated to develop this pilot programme that has now expanded the skills of the nurses which in turn benefits their patients.”
Many Donegal patients undergoing active oncology treatments travel to their treating cancer unit – Letterkenny – several times for blood sampling, medication management and care, and management of central venous access devices (these are devices that are fitted to patients through which chemotherapy drugs are administered).
Once fitted these lines have to be maintained and managed, with patients routinely returning to the hospital and in some cases this involves patients travelling long distances.
This new programme has been devised to provide nurses with the appropriate skills to safely assess and manage a patient at home, reducing the number of hospital visits for interventions.
Patients are identified as suitable for community nursing intervention by the Consultant Medical Oncologist (in Letterkenny General Hospital this is Dr Karen Duffy) and are referred by the specialist cancer team.
If a patient is symptomatic or requires a medical assessment while undergoing active cancer treatments and being cared for in the community, they are referred either immediately or urgently back to their local treating cancer centre.
Developed on a pilot basis in Letterkenny, the programme was initiated last September with nine Donegal Public Health Nurse participants. The six month programme included classroom based theory, the development of clinical skills under supervision and the subsequent application in the community.
While the PHNs who participated in the course are already qualified and skilled, the cancer education programme has enabled them to expand the range of services they can bring to their clients.
The nurses who completed the course are already managing the home care of LGH cancer patients. Once deemed suitable for such home care, patients are maintained under the care of the Consultant Medical Oncologist at LGH while undergoing active chemotherapy care but managed in the community by the PHN.
Dr Anne Flood, Director of Nursing at LGH said that the nurses had enhanced their overall knowledge and information base around cancer care, services and had enhanced their knowledge and links into the satellite centre at LGH as well as gaining greater insight into the working of all designated cancer centres.
She noted: “The choice of LGH at which to base this initial pilot and the manner in which it has allowed us work with our community colleagues has been extremely worthwhile. We are pleased that Letterkenny was chosen and delighted that Donegal patients are the first nationally to benefit. For the hospital it will reduce the number of times this patient group will have to return and in turn it will mean that extra patients can be seen as a result.”
Nationally, the new course was developed with the HSE Office of the Director of Nursing Services and supported by the National Strategic Nurse Reference Group. Dr Laffoy paid particular tribute to Ms Mary Wynne Interim Area Director, Nursing and Midwifery Planning and Development, Dublin North East for her commitment to the project and her important role in its development.
The programme underpins the comprehensive and skilful work already being carried out by the PHNs and all community based nurses in the county. These nurses are committed to providing a very diverse and skilful range of services and in expanding and developing the level of care they provide, they are better placed to serve the needs of their clients. Nurses will quickly identify any issues that arise for their patients and determine whether the patient requires a visit to hospital or can continue to be managed at home.
The course will now be offered across the country in association with the eight designated cancer centres and will ultimately benefit hundreds of cancer patients nationally.