Nurse-led care in oncology haematology clinic

Patricia Carroll, CNM2 CIT-OPAT MRHT; Louisea Burke, Director of Nursing, MRHT; Yvonne Delaney, Interim Director of Public Health Nursing, Laois/O aly; Linda Veighey, CRGN CIT Laois/O aly; and Siobhan Geraghty, ADPHN CIT Laois/O aly.

Extraordinary Measures

Nurse-led oncology-haematology clinic shows integrated care in a changing landscape

Extraordinary measures were initiated across the HSE during the pandemic and exploring means to reduce unnecessary hospital attendance was a key priority.

The Public Health Nursing Service of Laois/O aly Community Healthcare Organisation (CHO 8) and the Midlands Regional Hospital Tullamore (MRHT) initiated a quality improvement collaborative by establishing a nurse-led Oncology-Haematology Clinic. Service users that previously attended the Regional Oncology -Haematology Day Unit (ROHDU) in MRHT could now access specific services in the nurse-led clinic.

MRHT provided the relevant oncologyhaematology competence by assigning an experienced, skilled nurse to provide this service. Public Health Nursing Services also provided a registered nurse to facilitate service provision and primary care hosted the oncology-haematology clinic in the Primary Care Centre in Tullamore. The establishment of this dedicated service provides services such as chemotherapy disconnections, PICC line dressings, blood extraction, central venous access device port flushes and subcutaneous and intramuscular therapies specific to oncology-haematology patients.

In 19 months to October 30th 2021, the nurse-led clinic as a joint working partnership with no additional resources allocated has facilitated 1357 patients; a fine example of collaborative practice in achieving patient-centred care.

Patricia Carroll CNM 2, CIT – OPAT, MRHT, Siobhan Geraghty, Assistant Director of Public Health Nursing, community intervention team (CIT), and Linda Veighey, Community RGN, CIT, are responsible for the operation of the clinic under the governance of both Yvonne Delaney, Interim Director of Public Health Nursing Laois/O aly, and Louisea Burke, Director of Nursing MRHT, who have both encouraged and supported this integrated working.

“Patricia, Siobhan and Linda have been instrumental to the success of this clinic. I would like to send my sincere appreciation for their on-going dedication,” said Yvonne Delaney.

Sta of the ROHDU MRHT communicate with the Community Intervention Team- Out-Patient Antimicrobial Therapy (CIT-OPAT) Nurse in MRHT when they seek to make a referral to the nurse-led clinic in the PCCT. The governance of these service users remains at all times with their treating consultant at MRHT.

This collaborative nurse-led clinic has resulted in many positive impacts for the service user who attended this clinic over a number of months. Aside from the therapeutic relationships formed with the service user, the feedback has been very encouraging and indicative of a real success story. Evidently, the nurse-led clinic has greatly reduced waiting times; has reduced duration of episodes of care; service users are allocated an appointment time with care completed within 20 to 30 minutes from arrival to departure within the primary care centre.

The feedback from our service users has been phenomenal citing that they ‘feel safe’ and with greatest impact; ‘do not have to travel long journeys’ to seek relevant intervention, resulting in avoidance of unnecessary attendance in the acute setting and subsequent reduced risk of infection.

One patient said, “During my time attending and still attending I found the experience stress free… and I found the one-to-one personal service made my life so much easier. Due to the swift professional and caring service it provides it eliminates long waiting times for patients. I would highly recommend this service to continue.”

“These positive outcomes have ultimately led to greater patient satisfaction simply by delivering specialist care in the least complicated manner with patients accessing this service within their locality, upholding the ethos of primary care and bringing to life the principles of Sláintecare,” added Yvonne.