Evidence and Practice
Dementia complicates cancer treatment and care and there can be many challenges
Why you should read this article • To recognise that medication errors in cancer settings are a common cause of unintended harm to patients • To identify the factors that contribute to medication errors in cancer settings, including those that relate specifically to nurses • To be aware of strategies that can reduce the risk of medication errors in cancer settings There is a high incidence of medication errors across the NHS that results in significant harm to patients. There is also a lack of literature that explores the incidence and effect of medication errors in specialist cancer settings. However, the underlying factors that contribute to medication errors are universal across all settings. This article explores the risk factors relating to medicines administration in cancer settings – in particular systemic anti-cancer therapy and opioids – and the multifactorial causes of medication errors at the prescription, dispensing and administration stages. The authors suggest steps that can be taken to reduce the risk of medication errors and consider the role of education and non-medical prescribing.
A literature review of cancer assessment and treatment for people with learning disabilities
Emphasis on risk of exposure to asbestos in high-risk jobs may have obscured others at risk
Why you should read this article: • To enhance your knowledge of adrenal incidentaloma and the issues that patients with this condition may experience • To understand how digital technology could be used to support patients newly diagnosed with long-term conditions • To identify how online and web-based information and support programmes could be adapted to support patients with adrenal incidentaloma An adrenal incidentaloma is a mass discovered on the adrenal glands when patients have an investigative scan for an unrelated reason, and is considered a long-term condition. Online resources for people with other long-term conditions can provide information and advice on self-management, which can reduce their stress and anxiety. This article reports findings of a literature review on the effectiveness of using digital technology and digital communication methods to support patients newly diagnosed with a long-term condition. No evidence was found on this topic in relation to adrenal incidentaloma, so the literature on other long-term conditions – specifically cancer, diabetes mellitus and human immunodeficiency virus (HIV) – was reviewed. The article suggests that, despite the limited data on digital technology to support newly diagnosed patients with adrenal incidentaloma, online and web-based information and support programmes are used successfully for patients with other long-term conditions. Therefore, these programmes could be adapted or developed for this patient group.
Why you should read this article: • To learn about the risks of exposure to systemic anticancer therapy agents • To read about methods of minimising the risk of exposure to systemic anticancer therapy agents • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Many agents used for systemic anticancer therapy (SACT), which include chemotherapy drugs, monoclonal antibodies and other biological therapies, are known to be carcinogenic, teratogenic and mutagenic. Occupational exposure to SACT agents carries a proven risk of short- and long-term adverse health effects such as nausea, headaches, dizziness, hair loss, impaired fertility and cancer. The risk of contamination exists not only for staff who prepare or administer SACT agents, but also for those involved in transport, storage and waste disposal. In the UK, the handling of SACT agents is subject to a series of laws, regulations and guidelines. However, there are still inconsistencies in practice and a lack of awareness of the risks involved and need for training. The necessary preventive measures are not always in place and some staff remain exposed to cytotoxic agents. Furthermore, the risk of occupational exposure to SACT agents has intensified in recent years due to a significant increase in their use. This article prompts nurses to reflect on the health risks associated with handling SACT agents and the preventive and protective measures required.
Use of CDK4 and CDK6 inhibitors in patients with breast cancer
Oral complications can cause distress, long-term complications and increased morbidity
A systematic approach for nurses at any level or experience to engage with service evaluation
Receiving a new diagnosis of cancer or of its recurrence is distressing and there are increasing numbers of people living with the disease, some taking continuous treatment, as well as others who have been cured. Living with cancer and the possibility of recurrence requires psychological strength to deal with the treatment, effects of the illness and uncertainty about the future. The attributes of self-efficacy and psychological well-being can reduce the effects of chronic stress. Excellent symptom control is essential and fatigue, the most prevalent and often most distressing symptom for those with cancer, requires targeted support. Well-being and psychological resilience may be improved by specific actions and psychological approaches, some of which are encompassed by Foresight Mental Capital and Well-being Project’s (2008) five ways to well-being framework, which can be used to deliver personalised care. This is the second of a two-part article that reviews interventions promoting well-being and resilience in patients living with cancer. It describes the framework and suggests practical ways in which clinicians can integrate it and other interventions into clinical practice. It also offers time out exercises and a multiple choice quiz to aid readers’ learning and test their knowledge.
There is increasing recognition of the importance of making the Recovery Package available to more people affected by cancer. The cancer treatment summary is one of the core components of the Recovery Package and aims to improve communication between secondary and primary care, and help patients manage their care following treatment. The Somerset, Wiltshire, Avon and Gloucestershire Cancer Alliance is developing a suite of best practice treatment summary templates for each cancer site to improve the quality of the information in the documents, and to support cancer teams to begin the process of introducing them to practice.