Research Week Abstract Book - Northern Health

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Haematology IMProVING Pre ChemoTHERAPY EDUCATION ProCess FOR PATIENTS IN THE Day ONCOLOGY UNIT Gwynne M, Probst K, Edwards M, Cooney M. Background: Pre chemotherapy education is an integral part of patients’ treatment journey. Education in the Day Oncology Unit was performed on the day of the patients’ first treatment, with an allocated time frame of 30 minutes. Concerns were raised from nursing staff that patients’ anxiety levels were high and too much information was given on their first treatment, resulting in patients’ feeling overwhelmed. Staff also felt that 30 minutes was not enough time to interact and allow the patient quality time to raise their concerns, Aims: To provide a structured chemotherapy education process, allowing sufficient time for nurse and patient, provide a physical space away from treatment area for education and to decrease patient anxiety prior to treatment. Method: A project group was formed, and literature reviews were conducted. A study conducted by Peter MacCallum Cancer Institute in 2008 on ‘Reducing Stress in Patients Undergoing Chemotherapy’ was reviewed, as well as relevant oncology evidence based websites. Results: Based on the literature review, in January 2012 a new process for education was implemented. Patients are scheduled for pre chemotherapy education 2 days prior to treatment for an allocated time frame of 1 hour with a nurse. An education room has been established in the unit for privacy. Patients are given a “Looking after Yourself during Chemotherapy” DVD prior to their education session along with a questionnaire to be completed raising any concerns or fears they may have. A patient satisfaction survey was conducted in November 2012, highlighting that patients were 100% satisfied with the education process and they felt the content of information given was very helpful. Conclusion: Nursing staff reported a significant change in patient anxiety levels on the day of treatment when education had been conducted 2 days prior. Staff expressed that the extended time frame allowed them to deliver a more comprehensive education to the patient and they did not feel under pressure, or rushed. Improving the education process has provided patients with confidence, better understanding and reduced anxiety levels for their first treatment. 28 Research Week Abstract Book Northern Health 2013
Haematology HaematOLOGY HIGH-DOSE METHOTREXATE FOR THE TREATMENT OF RELAPseD Csn ERDheim CHESTER Disease Ho P and Smith C. Background Erdheim-Chester disease (ECD) is a rare non-Langerhan’s histiocytosis with multi-system involvement including central nervous system (CNS) disease which confers a poorer prognosis. There is no definitive treatment for ECD, though interferonalpha may be useful for non-CNS disease, if given for more than 3 months. Case Report A 60-year old lady with a 5-year history of stable non-CNS ECD presents with 4 days of diplopia and right arm numbness. Neurological examination revealed a horizontal gaze palsy and right arm paraesthesia. The MRI demonstrated extensive brainstem/cerebellar lesion but the PET/CT revealed stable systemic disease. CSF analysis showed raised protein (3.12g/L) but no evidence of infection or malignancy. During the first 72-hour period, the patient developed dysarthria and ataxia, necessitating urgent treatment. Interferon-alpha was not ideal due to its slow onset of action and poor CNS penetration. High-dose methotrexate was chosen due to its excellent CNS penetration and known therapeutic effect on CNS lymphoma. This treatment arrested the rapid progression and led to significant improvement in her speech and ataxia. A post-induction MRI showed a reduction in the size of the brainstem/cerebellar lesion and CSF protein reduced. The patient remained stable with ongoing high-dose methotrexate for 4 months, but subsequently developed new right-sided weakness and an increase in the size of her brainstem lesion. She is currently being treated with interferon-alpha. Conclusion We describe a case of CNS relapse of ECD in the setting of well controlled systemic disease. High-dose methotrexate was an effective initial salvage agent but further systemic treatment (e.g. interferon-alpha) may be necessary for a sustained longterm response. 29
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Page 5 and 6: Introduction Health Literacy And Cl
Page 7 and 8: Introduction cont’d IntRODUCTION
Page 9 and 10: Event Schedule cont’d event sched
Page 11 and 12: ABSTRACTS Abstracts 9
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Page 15 and 16: Aged Care Aged Care A COMParison OF
Page 17 and 18: Aged Care Aged Care FALLS TRENDS WI
Page 19 and 20: Aged Care 17
Page 21 and 22: Chronic Disease Management A SYSTEM
Page 23 and 24: Chronic Disease Management APProPri
Page 25 and 26: Chronic Disease Management INTRODUC
Page 27 and 28: CHROnIC DISEASE Management 25
Page 29: Haematology HaematOLOGY THE IMPleme
Page 33 and 34: Haematology HaematOLOGY Intermitten
Page 35 and 36: HaematOLOGY 33
Page 37 and 38: Women’s Health and Paediatrics MU
Page 39 and 40: Women’s Health and Paediatrics TH
Page 41 and 42: Women’s Health and Paediatrics IM
Page 43 and 44: Women’s Health and Paediatrics SA
Page 45 and 46: Health Service Evaluation ESTablish
Page 47 and 48: Health Service Evaluation EValuaTIN
Page 49 and 50: Health Service Evaluation INNOVATIV
Page 51 and 52: Health Service Evaluation EMERGENCY
Page 53 and 54: Health Service Evaluation Northern
Page 55 and 56: Orthopaedics ORTHOPAEDICS DisTAL RA
Page 57 and 58: Orthopaedics ORTHOPAEDICS RETURNING
Page 59 and 60: Orthopaedics ORTHOPAEDICS THEATre S
Page 62: Broadmeadows Health Service 35 John

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