I no longer feel alone with this

Transcription

1 I no longer feel alone with this Supportive cancer care by non-cancer community nurses in regional Victoria

2 Or Its all about

3 2010 It all started here Feeling isolated Desire for local support Partnership between care providers

4 2013 Goal: That every patient experiencing cancer in the Wimmera area feels supported and receives the best care at the right time as close to home as possible

5 Implementation Plan Model of Care Improve Supportive Cancer Care EFT to Cancer Resource Nurse Position in 4 Wimmera Southern Mallee health services Improve Clinical Services to people with cancer Audit clinical services and investigate capacity to deliver close to home by extending skills of existing nursing staff Identify & support opportunities for increased clinical cancer care across the Wimmera Wimmera Cancer Care Community of Practice Supports the development of the Cancer Resource Nurse role & embed within each health service Support nurses in each health service to maintain & build skills in providing clinical services to people with cancer Ensure robust evaluation underpins the Wimmera Cancer Care Coordination Service model Typo!

6 Wimmera Southern Mallee Health Alliance (WSMHA) Health Services Edenhope & District West Wimmera Rural Northwest Dunmunkle Wimmera Health Care WSM Economic Base Broadacre agriculture Challenges Ageing population Population decrease except Horsham Climate change, water supply and security WSMHA aims to improve well-being in the region Cancer Treatment High regional self-sufficiency but not always close to home If outside the region it may be north or south & outside region or west out of the state

7 Cancer Resource Nurses (CRN) Supporting people affected by cancer in their local community Providing: Support Information Education coordination for individuals & community Links to community and specialist cancer services Wimmera Cancer Nurse Practitioner (for complex care) Carmel O Kane P: E: carmel.o kane@whcg.org.au West Wimmera Health Service Janine Clark P: E: crn@wwhs.net.au Kaniva Apsley Edenhope Harrow Goroke Nhill Rainbow Jeparit Natimuk Horsham Patchewollock Woomelang Hopetoun Beulah Warracknabeal Sheep Hills Boolite 3 hrs Minyip Coromby Murtoa Rupanyup 3 hrs 50 mins from Ballarat Rural Northwest Health Hopetoun Kathleen Poulton P: E: crn@rnh.net.au 2 hrs 30 mins Dunmunkle Health Service Minyip Campus Di Knoll P: E: crn@dunmunkle.com.au Murtoa Campus Janine Matthews P: E: crn@dunmunkle.com.au Edenhope and District Memorial Hospital Cath McDonald P: or Adrienne Caldow P: E: crn_referral@edmh.org.au Ballarat

8 Cancer Resource Nurse The CRN role will be a component of an existing Division 1 Nurse already based in each Wimmera health service. Purpose: To provide psychosocial support to people and their families during their cancer experience. CRN role to provide: Supportive Care: Support patients, carers and their families at diagnosis, during and after active treatment in navigating the individual s health and emotional needs. Information: Be a local cancer resource and source of current and relevant cancer information Liaison: Act as a liaison between local and regional healthcare providers. Advocacy: Respond to local needs and advocate for services or information as required. Referral: Refer patients to appropriate services for issues outside the scope of practice of the CRN role.

9 Education and skills - framework The following education is mandatory for CRNs to undertake the position. Recognition of prior learning will be acknowledged. 1.One-Day Induction Program (face-to-face) 2.Cancer Survivorship: A practical guide for Primary Health Care nurses (online) 3.No health without mental health: The link between chronic illness and mental health including cancer (online) 4.Communication skills training (face to face) 5.Regional Tour: WHCG (DOU), BOHS, StJoG (face-to-face) Other opportunities to build CRN workforce capacity will be fostered using the following mechanisms (based on individual learning needs). Wimmera Cancer Care Community of Practice (WCCCoP) bi-monthly meetings Additional education opportunities offered within individual health service education programs, highway education model and e-learning platform. Poster 20: Regional Education Poster 1: Regional networking & collaboration

10 Cancer Resource Nurse Scope of Practice Level Purpose CRN Responsibility 1 Provision of information Yes 2 Sign posting/ referral to other services Yes 3 New patient assessment of psychosocial and physical needs Yes 4 Patient & Family Yes 5 Complex ongoing intervention No Cancer Nurse Practitioner Poster 26: CDU redesign

11 Four elements to the CRN interim evaluation report 1 2 Pt satisfaction Episodes of care Health professional CRN assessment 4 3

12 Consumers satisfaction surveys responses I no longer feel alone with this I would recommend this service to anyone Helps me know that it is ok to ask for help Invaluable service and sorely needed Saved me travelling

13 Episodes of care CRN Patients seen Total episodes Public event Information hub HS Range 1-16 HS Range > 330 attendees 6 > 110 attendees 25 information top-ups: GP clinics, pharmacies, health services Not available HS 3 & 4 No data available at time of report Total 46 across 3 LGAs and 9 postcodes > 450 people Reflective of community information needs Pt age 20s 30s 40s 50s 60s 70s 80s Contacts % % >

14 CRN evaluation of own role (n=2) KNOWLEDGE OF PRIMARY CARE PATHWAYS KNOWLEDGE OF CANCER REFERRAL PATHWAYS 3.5 KNOWLEDGE OF CANCER RESOURCES 4 KNOWLEDGE OF NEEDS OF CANCER SURVIVORS Poster 14: Radiation therapy nurses info & pt satisfaction KNOWLEDGE OF RISK FACTORS FOR DISTRESS KNOWLEDGE OF SUPPORTIVE CARE SCREENING KNOWLEDGE OF SUPPORTIVE CARE EDUCATION (AVERAGE OF 7 ELEMENTS) LEVEL OF SATISFACTION WITH ROLE Likert 2 scale, 1=poor, 3 5=excellent Health professional survey Health Professional CRN Survey Responses (%) CRN Self-assessment Aware of CRN scope of practice Communication received from CRN Continue to refer to CRNs Eligible clients for referral to CRNs Response to survey - medical specialists Response to survey - nurses Already know about the role

15 CRNs Value Data for analysis Confidence Cost benefit Loss of momentum Re-appoint Limitations a project thus officer far Awareness of role Regional cancer services CRN role development Project support Referral pathways Integrated

16 Grampians Integrated Cancer Service Vision: Improving patient experiences and outcomes by connecting cancer care and driving best practice

17 Nat: Line manager Kathy: CRN Tracey: Project Officer

18 Lived in remote area Tree change Renovator s special! Animals her life Wouldn t let people into her home No formal referral process to CRN Helen reluctant for further contact Rough family history Unaccepting of diagnosis Helen- Independent woman in late 50s Local PAG nurse suggested CRN referral CRN met informally 2/52 later, no further connection GP admitted for pain control a few weeks later CRN steps in 354 kms from home Over 4 hours away Helen transferred to Pall Care in another regional city CRN organised local person to deliver feed for goats Helen worried about goats being fed CRN working in ward that day Helen and CRN regular phone calls Reconciled with family Community effort to care for animals Helen dies Interaction over 4 months

19 21 goats Some pregnant Herded by CRN and husband Helen s family took ring-necked parrots Its all about Slim rehoused twice Homes found for cats

20 I no longer feel alone with this