BACKGROUND:Western Health (WH) is a major provider of care for Colorectal Cancer patients (CRC). During 2012-2013 there were 2903 CRC admissions, representing the largest service provider within the Western and Central Melbourne Integrated Cancer Service (WCMICS). WH manages 36% of colorectal malignancies for the Western region causing increasing pressure on outpatient clinics. There was a need to explore alternative models of care as there was little capacity for clinicians to focus on psychosocial or survivorship issues due to pressures in accommodating the volume of CRC patients.
METHODS: To adopt a model of care where the presence of an Advanced Practice Nurse (APN) can:
• Provide Supportive Care Screening
• Identify ongoing issues and facilitate appropriate referrals
• Direct patients and carers to appropriate resources
• Provide patients an individualised Survivorship Care Plan
• Communicate with General Practitioners (GP)
RESULTS: A total of 42 patients were seen by the CRC Follow Up Nurse. 72% were aged 60 years and over, 57% were female and 75% had a preferred language of English. All patients were offered a Supportive Care Assessment (SCA) and an individualised CRC Follow Up Care Plan. SCA was completed for 36 patients. Despite having completed their cancer treatment, many were still experiencing physical symptoms and psychosocial issues that would benefit from referral to supportive care services.
CONCLUSION: There is a need for an APN role for CRC, most notably in the areas of patient/family education, information provision, SCA and GP communication. This intervention would be more beneficial at the start of the patient’s cancer journey, as early as diagnosis and pre-admission clinic. Most patients who described distress or required additional support demonstrated issues early on in their illness/treatment trajectory, however there were no resources to address these problems comprehensively.