This project set up a nurse-led community clinic for patients with a Central Venous Access Device.
In Northern Ireland, 11,700 people were diagnosed with cancer in 2010 and 1755 patients had a PICC/Hickman line inserted for chemotherapy administration. Patients who have a CVAD – a central venous access device through which drugs are given directly into the bloodstream – have serious illnesses and many have to travel long distances to a hospital or cancer centre to have their lines managed.
Patients who have a CVAD – a central venous access device through which drugs are given directly into the bloodstream – have serious illnesses and many have to travel long distances to a hospital or cancer centre to have their lines managed.
This can cause stress on both patients and carers. Many patients have central lines for receiving chemotherapy, making them very lethargic and nauseated; this is made worse when travel is involved. The development of local clinics would allow patients to be treated near their own home by familiar staff. Providing a convenient and accessible local service will reduce emotional and physical stress to patients and carers and bring care closer to home.
Outcomes
An accessible cost effective CVAD service was developed in Castlewellan and successfully implemented.
There was a reduction in costs by providing a community nurse-led CVAD service. The need for patients/clients visits to the Regional Cancer Centres were reduced. Eleven community nurses who rotated into the service improved their knowledge and skills in CVAD management. Following consultation within the South Eastern Trust’s CVAD Implementation Group the criteria for referring patients to the CVAD clinic evolved and are currently being agreed by management.
Patient Story
‘Mary’ is a 38 year old primary school teacher, living with her husband Peter and baby son. During her pregnancy, Mary noticed a small lump on her neck but was advised not to worry by her obstetrician. It wasn’t until giving birth and much persuasion on her part that she had a lump biopsy done. The lump turned out to be a Grade 2 Hodgkins lymphoma.
- Mary was started on a high dose chemotherapy regime in the Cancer Treatment Unit 36 miles away. The project team suggested that Mary attend the CVAD clinic. Initially, Mary was uncertain about leaving her small child so she was keen to know that attending the clinic would reduce her visits to hospital
- Mary attended the clinic on 18 occasions. Initially, she was very anxious to get home but gradually her anxiety lessened. She was able to stay in Castlewellan to do a bit of shopping and even meet a friend for lunch.
- Mary’s visits to the clinic ended in July 2011. To this day Mary still keeps in contact with the district nursing staff. She completed her treatment and is now in remission. On her final visit, Mary was asked how the CVAD service could be improved. She replied, “The only way I can think of, is to ensure that this service continues to be available to as many people as possible”.
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