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Collaboration for Optimum Patient Care

Collaboration for Optimum Patient Care. Prepared by Dixie-Lee Rosher RN, BSN, Ma Assessment Module Leader - CSI. Principles of Care. Collaborative Care Expertise in Care Continuity Care Appropriate Access. The Core Team . Patient Oncologist Radiation Therapist Physicist Nurse

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Collaboration for Optimum Patient Care

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  1. Collaboration for Optimum Patient Care Prepared by Dixie-Lee Rosher RN, BSN, Ma Assessment Module Leader - CSI

  2. Principles of Care • Collaborative Care • Expertise in Care • Continuity Care • Appropriate Access

  3. The Core Team • Patient • Oncologist • Radiation Therapist • Physicist • Nurse • Other Support Service Providers

  4. Focus Each Core Team Member • Patient • Oncologist • Radiation Therapist • Physicist • Nurse • Other Support Service Providers

  5. Which Tumor Sites are High Risk For Patients ? • Head and Neck • CNS • Dual Modality • Examples • GI - Esophagus • Lung • Pediatric Patients

  6. What are the High Needs for Patients? • Examples • Pre treatment health issues • Medication management • Dealing with reoccurrence • Palliative Symptom Control • Community support/family issues • Complex wound care • Fatigue issues

  7. Case Studies 1. Mr. DB - GI site (Dual Modality) 2. Mr. JB = Head and Neck Site 3. Mrs. A D - CNS Site

  8. Case Study1. Mr. DB - GI site (Dual Modality) 42 year old married man with 2 children in rural BC. Dx with poorly differentiated adenocarcinoma of the rectum T3N1M1. He had a liver metastasis resected. His father died of bowel cancer in his 80’s. His Tx plan was dual modality following surgical resection. The post-op treatment plan was standard 5FU/Folinic Acid and concurrent pelvic radiation. 4500cGy in 25 fractions

  9. 1. Mr. DB - Possible Issues • Expected side effects - XRT • Diarrhea • Skin reaction • Acute cystitis • Expected side effects - Chemo • Hematological (Neutropenia) • Stomatitis • Diarrhea • Nausea

  10. Collaboration Issues for Mr. DB • Monitoring of Diarrhea • Nutritional status • Skin care

  11. Case Study2. Mr. JB - Head and Neck Site 58 married man living 2 hrs. from CC in small community. 47+ pack year smoker. Rarely takes alcohol. Dx of squamous cell carcinoma of the left tonsil T4N0M0. He required extraction of his teeth. He was given a concurrent chemoradiation treatment protocol as there is a significant survival advantage.

  12. 2. Mr. JB - Issues • Expected side effects - XRT • Radiation Skin Reaction • Fatigue • Mucositis • Xerostomia • Altered taste • Expected side effects - chemo • N&V • Neutropenia • Diarrhea • Stomatitis

  13. Collaboration Issues for Mr. JB • Mucositis • Pain • Nutrition • Care of Radiation Skin Reaction • Emotional support

  14. Case Study3. Mrs. AD - CNS Site 52 year old married female living with her spouse. Dx of subtotal resected grade IV astrocytoma of the left temporal region. Previous history of Hodgkin’s disease 20 years prior treated with chemotherapy alone. Treatment plan included surgery, radiation therapy followed by chemo therapy. She received 5040cGy in 28 fractions.

  15. 3. Mrs. AD - Issues • Expected Side effects - XRT • Increased intracranial pressure • Fatigue • Alopecia • Memory Loss • Expected Side effects - Chemo • Chemo was planned to occur following XRT so would not be an issue during radiation therapy.

  16. Collaboration Issues for Mrs. AD • N&V • Memory changes • Neurological changes • Gait changes • Decadron monitoring • Seizure activity • Dilantin level • Pain • Headaches

  17. Collaboration = Appropriate Patient Care • Patient Satisfaction • Communication • Documentation • Care Planning • Care Provider satisfaction • Quality Management • Research opportunities

  18. Questions or Comments

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