Enhancing the pre-admission process for a patient with breast cancer

Abstract

Objective: The purpose of this paper is to detail the development and implementation of a patient focused pre-admission process, part of which is the check list identified within this paper and comprising the main point of the paper because it is based on patient and publication evidence for women with breast cancer. Women with breast cancer together with health professionals had specific input into the designed pre-admission clinic at a tertiary care hospital. A pre-admission clinic had been established some time ago however, women who attended this clinic deemed it most unsatisfactory for their needs. Results from an evaluation provided information that indicated women with breast cancer required an improved pre-admission process that was aligned to their needs and those of the Breast Cancer Multidisciplinary Team (BCMT). Setting: A large tertiary care hospital in Sydney, New South Wales, Australia. Subjects: Fifty (50) women of mixed cultures. Men can be diagnosed with breast cancer however, throughout this project, women were the only patients presenting for surgery. Primary Argument: Even though remarkable progress has been made in breast cancer survival through medical treatment, women, newly diagnosed with breast cancer are frequently concerned, stressed and anxious as they attempt to come to terms with the news on their cancer diagnosis. Beside the initial medical consultation that informs them on their diagnosis, the women’s first major interaction with the healthcare system commences when they attend the preadmission clinic as a pre-admitted person. Therefore it is appropriate to examine current nursing practices during the pre-admission phase of a Tertiary Hospital so women, newly diagnosed with breast cancer are able to receive appropriate and supportive care. The goal of health professionals is to respect each patient and give voice to them by developing a specifically designed pre-admission process. It is expected any pre-admission process will utilise available evidence and include consultation with the Breast Cancer Multidisciplinary Team (BCMT). Thus the project commenced by identifying the needs of women with breast cancer in consultation with the BCMT, including nurses, physiotherapists, doctors and social workers. This evidence based approach to best practice in the pre-admission process and clinic has not been attempted previously for this cohort of patients. Conclusion: Improving the pre-admission process of patients encourages analysis of the evidence that is appropriate for this cohort and nursing practices. In addition, it offered time to ensure applicability of the pre-admission process and clinic to the lives of the women concerned. During this project opportunities arose for reflection on the journey women follow after their diagnosis and the involvement of the BCMT. Moreover, this process encouraged examination of the most appropriate allocation and use of resources within the context of the pre-admission process and clinic, surgery, and discharge through to home follow up. This paper maps some of the adopted process, the collected data and briefly summarises resources utilised in relation to the pre-admission process.