Adult Oncology Unit Research Articles

Establishing a Multi-disciplinary Adult Oncology Unit at Muhimbili National Hospital: Lessons Learned, Challenges, and Opportunities Amidst Tanzania's Growing Cancer Burden

In light of the escalating cancer burden in Tanzania, Muhimbili National Hospital (MNH) embarked on a transformative initiative, utilizing the Capability, Opportunity, Motivation (COM-B) framework to meticulously design an implementation strategy. This collaborative effort yielded a dedicated chemotherapy ward, an expanded workforce, and ongoing professional development programs. The success of MNH's Adult Oncology Unit highlights the critical significance of adaptability, stakeholder engagement, and an unwavering commitment to meet the rising demand for cancer care in resource-constrained environments.

"Establishing a Multi-disciplinary Adult Oncology Unit at Muhimbili National Hospital: Lessons Learned, Challenges, and Opportunities Amidst Tanzania's Growing Cancer Burden"

The escalating cancer burden, particularly in low- and middle-income countries such as Tanzania, necessitates innovative strategies. One strategy is to increase access to cancer services through the establishment of treatment in existing referral hospitals that offer multidisciplinary care, as was the case in the opening of the adult oncology unit at Muhimbili National Hospital (MNH) in Tanzania. A comprehensive facility assessment served as the foundation for this expansion, encompassing assessments of the spatial requirements of human resources, equipment, and drug availability. Aiming to ensure optimal resource allocation and effective implementation by capitalizing on existing systems. The main objective of opening the MNH adult oncology unit was to increase coverage and accessibility to comprehensive cancer care services. This initiative has substantially improved patient outcomes, with reduced wait times for oncology care initiation, facilitating seamless care coordination that capitalizes on multidisciplinary treatment planning. The unit has provided benefits to MNH by fostering collaborative efforts, serving as a revenue generation point, and expanding care that aligns with institutional goals. Nonetheless, challenges persist, including space constraints and an inadequate number of trained human resources for oncology care. The successful establishment of the MNH's adult oncology unit exemplifies the significance of stakeholder engagement, adaptability, and collaboration. A comprehensive approach that emphasizes workforce development, community awareness, and infrastructure enhancement offers promise in confronting Tanzania's mounting cancer burden.

Implementation of the Adult Oncology Unit at Muhimbili National Hospital (MNH)

The escalating cancer burden, particularly in low- and middle-income countries such as Tanzania, necessitates innovative strategies. One such strategy is increasing access to cancer services through the establishment of treatment in existing referral hospitals that offer multidisciplinary care, as was the case in the opening of the adult oncology unit at Muhimbili National Hospital (MNH) in Tanzania to address the burgeoning cancer crisis. A comprehensive facility assessment served as the foundation for this transformation, ensuring optimal resource allocation and effective implementation. The rising cancer burden in Tanzania is dominated by cervical, breast, and prostate cancers. However, reported figures might underestimate the issue due to the lack of a centralized national cancer registry and limited access to diagnostic and treatment facilities throughout the country. The MNH oncology unit's creation aimed to decentralize care from the Ocean Road Cancer Institute (ORCI); as the cancer burden increased over the years, the center was getting strained by demand. The MNH facility assessment encompassed assessments of spatial requirements for human resources, equipment, and drug availability. This unit adopts a multidisciplinary approach, enabling personalized treatment plans and collaborative decision-making, aimed at expanding capacity and promoting inter-departmental cooperation. A "train-the-trainer" model empowered nursing staff in chemotherapy administration, and pharmacist involvement ensured accurate medication management. This initiative has substantially improved patient outcomes, with reduced wait times for oncology care initiation, facilitating seamless care coordination that capitalizes on multidisciplinary treatment planning. The opening of the oncology unit has given benefits to MNH through fostering multidisciplinary collaboration, an increase in revenue generation, and the expansion of care that aligns with institutional goals. Nonetheless, challenges, including space constraints and an inadequate number of trained human resources for oncology care, persist. The successful establishment of MNH's adult oncology unit exemplifies stakeholder engagement, adaptability, and the significance of collaboration. A comprehensive approach, emphasizing workforce development, community awareness, and infrastructure enhancement, offers promise in confronting Tanzania's mounting cancer burden.

Implementing a Fall Prevention Protocol to Reduce Fall Rates Among Inpatients With Cancer.

Globally in healthcare delivery, inpatient falls and fall-related injuries contribute to unsafe patient care environments. On two inpatient oncology units, the frequency of patient falls had increased, despite the use of a fall screening tool. This project aimed to determine whether implementing the Agency for Healthcare Research and Quality (AHRQ) 3B Scheduled Rounding Protocol would reduce the average daily fall rate and number of fall-related injuries on two adult inpatient oncology units. This quantitative, quasi-experimental quality improvement project evaluated the implementation of the AHRQ protocol to reduce the average fall rate and number of fall-related injuries for adult patients with cancer. The average daily fall rate decreased following implementation of the AHRQ protocol, indicating clinical significance. This project's results suggest that implementing a standard fall prevention protocol can reduce the rate of patient falls.

Anticholinergic burden risk and prevalence of medications carrying anticholinergic properties in elderly cancer patients in Jordan

BackgroundGeriatric cancer patients are susceptible to adverse drug events due to the complexity of their chemotherapy regimens and collateral treatments for their comorbid conditions. Prescribing medications with anticholinergic burden characteristics can complicate their condition, leading to negative impacts on their health outcomes and quality of life, including an increase in adverse drug event frequency, physical and cognitive impairments. ObjectiveThis study aims to examine the prevalence of anticholinergic prescribing and identify the cumulative anticholinergic load risk associated with drugs prescribed to elderly cancer patients. Also, to identify the predictors that might lead to raised anticholinergic burden in these patients. MethodologyThis retrospective cross-sectional study included elderly patients (age ≥ 65) diagnosed with cancer and admitted to the adult oncology unit at King Abdullah University Hospital (KAUH) in Jordan during the period between (January 1st, 2019, and January 1st, 2022). The medication charts of 420 patients were evaluated for study outcomes. ResultsOf the total subjects, females represented 49.3%, and the average age was 72.95 (SD = 7.33). A total of 354 (84.3%) patients were prescribed at least one drug carrying anticholinergic burden properties. Median for anticholinergic medications was 3 (IQR = 4). Our study found that 194 (46.2%) patients were at a high risk of adverse events associated with anticholinergic load (cumulative score ≥ 3). Metoclopramide, furosemide, and tramadol were the most frequently prescribed drugs with anticholinergic properties. Alimentary tract drugs with anticholinergic action were the most commonly encountered items in our study population. ConclusionOur study revealed a significantly high prevalence of anticholinergic prescribing among elderly cancer patients. Nearly half of the patients were at high risk of developing serious effects related to anticholinergic activity from the drugs administered. Polypharmacy was strongly associated with increased anticholinergic burden score. Evidence-based recommendations utilizing prescribing strategies for safer alternatives and deprescribing of inappropriate medications could reduce such inappropriate prescribing.

Nursing Care in Patient with Advanced Cancer: The Experience of the Adult Oncology Unit of Lomé

Nursing Care in Patient with Advanced Cancer: The Experience of the Adult Oncology Unit of Lomé

Implementation of a Quality Improvement Role for Unlicensed Assistive Personnel and Effects on Infection Prevention

Background: Care bundles comprise evidence-based practices and interventions that are easily and consistently implemented while improving patient outcomes. As patient acuity and task overload continue to increase, infection prevention bundle and process measure compliance and data collection may become a lower priority for registered nurses (RNs). In early 2019, a certified nursing assistant (CNA) began full-time quality liaison work on a 53-bed inpatient adult oncology unit at UNC Medical Center to provide targeted compliance data collection and to correct deficits in real time when possible and within the appropriate scope of practice. Methods: The quality liaison CNA is highly motivated, with a relevant clinical background and effective communication skills. After conducting a gap analysis, the unit developed specific responsibilities for several areas of quality improvement, including infection prevention. In addition to rounding on all patients daily, the quality liaison (1) performs direct patient care tasks like Foley catheter care, (2) conducts patient education on topics such as chlorhexidine gluconate treatments, (3) performs all relevant process measure audits, and (4) easily relays missed or needed care to RNs with a door sign created as part of this initiative. High-risk findings, such as a loose central-line dressing, prompt immediate communication to the RN, with follow-up and escalation when necessary. Results: Patients and staff received the quality liaison well, and the increased attention to care bundle components and auditing ensured consistent, evidence-based care along with accurate and reliable data collection. Compared to the previous calendar year, the number of central-line audits on the unit increased by >1,400 by the end of 2019. Patient outcomes improved, and during 1 fiscal year, the unit achieved rate reductions between 40% and 55% for central-line–associated bloodstream infections, catheter-associated urinary tract infections, and healthcare-associated C. difficile infections. Staffing and logistical challenges imposed by the COVID-19 global pandemic have hampered this work because the quality liaison was redeployed to direct patient care intermittently. Correspondingly, from July to October 2020, the same infection rates increased between 30% and 353%. Conclusions: Having a designated quality liaison is an effective means to achieving quality improvements while remaining an integral member of the patient care team. As staffing has improved on this unit, the quality liaison has refocused efforts, and infection rates are beginning to improve. Given the success of the quality liaison role in improving quality outcomes on this unit, the hospital is exploring expansion of this model to additional units.Funding: NoDisclosures: None

Nursing Students' Knowledge and Attitude Toward Cancer Survivorship.

The number of cancer survivors is expected to rise to up to 20 million by 2026. It is of utmost importance that nurses who provide survivorship care enhance their knowledge and skills to meet the needs of cancer survivors. The purpose of this project is to propose a pilot evidence-based educational project to incorporate the concept and framework of the survivorship care plan for nursing students. We evaluated feedback from nursing students for their knowledge and attitude on cancer survivorship care. A pilot educational project was given to 38 undergraduate students and 17 graduate students. Pre- and post-test feedback were collected from these students. Content analysis was used to analyze the data. At least 60% of both undergraduate and graduate nursing students had experience in either adult or pediatric oncology units. Only 11% of undergraduate and 18% of graduate students reported awareness of survivorship care plans. However, all of the students believed the survivorship care plan will be helpful for cancer patients. We recommend that it is imperative to incorporate the concept of cancer survivorship in the early stage of nursing education.

Impact of an Enhanced Prevention Bundle on Central-Line–Associated Bloodstream Infection Incidence in Adult Oncology Units

Background: Central-line–associated bloodstream infection (CLABSI) rates have steadily decreased as evidence-based prevention bundles were implemented. Bone marrow transplant (BMT) patients are at increased risk for CLABSI due to immunosuppression, prolonged central-line utilization, and frequent central-line accesses. We assessed the impact of an enhanced prevention bundle on BMT nonmucosal barrier injury CLABSI rates. Methods: The University of Iowa Hospitals & Clinics is an 811-bed academic medical center that houses the only BMT program in Iowa. During October 2018, we added 3 interventions to the ongoing CLABSI prevention bundle in our BMT inpatient unit: (1) a standardized 2-person dressing change team, (2) enhanced quality daily chlorhexidine treatments, and (3) staff and patient line-care stewardship. The bundle included training of nurse champions to execute a team approach to changing central-line dressings. Standard process description and supplies are contained in a cart. In addition, 2 sets of sterile hands and a second person to monitor for breaches in sterile procedure are available. Site disinfection with chlorhexidine scrub and dry time are monitored. Training on quality chlorhexidine bathing includes evaluation of preferred product, application per product instructions for use and protection of the central-line site with a waterproof shoulder length glove. In addition to routine BMT education, staff and patients are instructed on device stewardship during dressing changes. CLABSIs are monitored using NHSN definitions. We performed an interrupted time-series analysis to determine the impact of our enhanced prevention bundle on CLABSI rates in the BMT unit. We used monthly CLABSI rates since January 2017 until the intervention (October 2018) as baseline. Because the BMT changed locations in December 2018, we included both time points in our analysis. For a sensitivity analysis, we assessed the impact of the enhanced prevention bundle in a hematology-oncology unit (March 2019) that did not change locations. Results: During the period preceding bundle implementation, the CLABSI rate was 2.2 per 1,000 central-line days. After the intervention, the rate decreased to 0.6 CLABSI per 1,000 central-line days (P = .03). The move in unit location did not have a significant impact on CLABSI rates (P = .85). CLABSI rates also decreased from 1.6 per 1,000 central-line days to 0 per 1,000 central-line days (P < .01) in the hematology-oncology unit. Conclusions: An enhanced CLABSI prevention bundle was associated with significant decreases in CLABSI rates in 2 high-risk units. Novel infection prevention bundle elements should be considered for special populations when all other evidence-based recommendations have been implemented.Funding: NoneDisclosures: None

PCN6 Thromboembolic Events Among Cancer Patients Treated with Chemotherapy at Adult Oncology Unit of Tikur Anbessa Specialized Hospital: A Retrospective CROSS-Sectional Study

PCN6 Thromboembolic Events Among Cancer Patients Treated with Chemotherapy at Adult Oncology Unit of Tikur Anbessa Specialized Hospital: A Retrospective CROSS-Sectional Study

Assessment of Turkish oncology nurses’ knowledge regarding COVID-19 during the current outbreak in Turkey

PurposeTo assess Turkish oncology nurses’ knowledge regarding novel coronavirus (COVID-19) during the current outbreak in Turkey.MethodsThis descriptive study was carried out with the 185 oncology nurses between April and May 2020 in Turkey. Research data were collected through online survey using “Nurse Information Form” and “Nurse Information Scale for COVID-19.” Multilinear regression analysis was used in determining the factors affecting oncology nurses’ information regarding COVID-19.ResultsAccording to the data delivered from 185 oncology nurses, 57.7% of the participants had an undergraduate degree, 74.1% were working in adult oncology units, and 52.4% of them were working as clinical nurses, 48.1% of the nurses received education for COVID-19 (51.9% did not receive) and 70.3% followed and read the COVID-19 Guidelines published by the Ministry of Health (29.7% did not follow guidelines). Using multiple regression analysis, a model based on the relationship between the variables was created. In the model, the descriptive characteristics of the oncology nurses and their experiences of COVID-19 were found to explain 29.1% of their knowledge level for COVID-19. Nurses’ education level, the presence of a relative diagnosed with COVID-19, and following the COVID-19 guidelines were found to statistically significantly affect the knowledge levels of COVID-19.ConclusionThese findings suggest that hospital management and the Ministry of Health should provide more information for the oncology nurses to better control of cancer patients from the infectious disease.

Incidence and Predictors of Recurrence among Breast Cancer Patients in Black Lion Specialized Hospital Adult Oncology Unit, Addis Ababa, Ethiopia: Retrospective Follow-up Study with Survival Analysis.

Currently, breast cancer is becoming a major public health problem for developing countries. In Ethiopia, breast cancer is the most prevalent cancer among women, and constitutes a major public health concern. Hence, this study was aimed to determine the incidence and predictor of recurrence among breast cancer clients at Black Lion Specialized Hospital, Ethiopia, in 2018. We analyzed 513 patients out of 835 women breast cancer patients treated at Black Lion Specialized Hospital. Recurrent-free survival was determined using the Kaplan–Meier method, with comparisons between groups through the log-rank test. The Cox proportional hazards model was used to identify predictors of recurrence among breast cancer clients. The incidence rate of recurrence among breast cancer was 6.5% per (95% CI = 6.49-12.47) follow-up. The median recurrent-free survival time was 60.33 months (95% CI = 54.46-62.30). Predictors of recurrence were negative estrogen receptor (hazard ratio [HR] = 1.8, 95% CI = 1.53-7.62), high histologic grade (HR = 2.8, 95% CI = 1.14-10.31), positive lymph node status (HR = 2.6, 95% CI = 1.14-10.31), clinical staging III (HR = 2.5, 95% CI = 1.26-9.42), and involved deep surgical margin (HR = 3.6, 95% CI = 2.14-8.61). This research showed that incidence of recurrence was high. Advanced clinical stage, positive nodal status, high histologic grade, negative estrogen receptor, and involved deep surgical margin were associated with higher recurrence rates. In contrast, hormonal therapy has a great role in decreasing the development of recurrence.

Complementary and alternative medicines used by cancer patients to cope with nausea

Background: Cancer is a common health problem in the world. Nausea is one of the most common symptoms in cancer patients. Cancer patients often apply to complementary and alternative medicines (CAM) in symptom management.Aim: The aim of this study was to determine the CAM methods used by cancer patients to cope with nausea.Material and Method: The study has a descriptive design and its data were collected in an adult oncology unit of a university hospital between July and September 2019. A total of 205 patients diagnosed with cancer for at least 6 months were included in the study. Data were collected by using the Individual Identification Form and Attitude Scale against Holistic Complementary Medicine. Data were analyzed with SPSS 25.0 package program. Written permission was obtained from the relevant ethics committee, hospital and participants to conduct the study.Results: Sixty and a half percent of the subjects were female and the mean age was 50.64 ± 15.27. While 31.7% of the patients had information about CAM, the main source of information was the internet and social media (64.6%). It was found that 14.63% of the patients applied to a CAM to cope with nausea. The most commonly used method is phytotherapy with 86.67%. The total score environment of the Holistic Complementary Medicine Attitude Scale was 33.49 ± 4.63.Conclusions: It was found that the rate of using CAM in coping with nausea in cancer patients was lower than other symptoms in the literature and the most commonly used method was phytotherapy. Patients' attitudes towards CAM were found to be positive.

Complementary and alternative medicines used by cancer patients to cope with chemotherapy-induced constipation

ObjectivesThe aim of this study was to evaluate complementary and alternative medicines (CAM) used by cancer patients to cope with chemotherapy-induced constipation, and attitudes of the patients toward CAM. MethodsThis descriptive study was conducted in an adult oncology unit of a university hospital with 214 cancer patients receiving chemotherapy. Data were collected with the Patient Identification Form and Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ). ResultsOf the participants, 21.5% had information about CAM, the main source of information was the internet and social media (54.8%), and 31.8% used CAM in coping with chemotherapy-induced constipation. The most common method was phytotherapy (97.1%). The most commonly used herb was apricot (39.4%); the HCAMQ mean score was 34.3 (±4.6). ConclusionCancer patients frequently use CAM to cope with chemotherapy-induced constipation and the most common CAM used by patients is phytotherapy.

Hospital care for adolescents with cancer in Spain: Needs, resources and organisational model

In Spain, adolescents with cancer are treated in Pediatric Onco-Hematology Units or in Adult Oncology Units. For this reason, the Spanish Federation of Parents of Children with Cancer carried out two surveys in 2013 and 2014 to know the differences in provision of psico-social services to the patients and their relatives among both types of Units. Twenty eight Pediatric and 18 Adult Units provided information. The results showed that the Pediatric Units were better adapted to the needs of the adolescent and family patients and to Spanish Health Authorities recommendations: more appropriate environment, resources for education and leisure, facilities to parents and relatives. Specialized Psycosocial care by psychologists and social workers is insufficient in both cases and the compliance with national and international recommendations is weak. However, specific adolescents’ Units are starting to be created in Spain, following the experiences in other countries that define the new role of nurse as an essential linchpin in the care team.

Impact of Structured Nurse Leader Rounds on Satisfaction With Nursing Care Among Patients With Cancer.

The patient satisfaction rate is considered a challenge for nurse leaders, especially among patients with cancer, due to the complexity of the disease, diagnostic procedures, and treatment. The purpose of this study was to evaluate the impact of structured nurse leader rounds (NLRs) on satisfaction with nursing care among patients with cancer. Moreover, we assessed the relationship among NLRs, patient satisfaction, and demographical variables. A two-group posttest design was used in four adult inpatient oncology units in a specialized oncology center. A stratified random sampling technique was utilized to select 169 patients for the experimental group (80 patients) and control group (89 patients). Structured leader rounds were conducted by nurse leaders using a scripted nurse leader tool to standardize the rounds in the experimental group, while the unstructured leader round was conducted in the control group. Patient satisfaction was measured using the Patient Satisfaction with Nursing Care Quality Questionnaire. The findings revealed that there was a significant difference in total score of patients' satisfaction between study groups (t = -9.213, p > .001). Conversely, the structured leader round has a significant impact on the patient's experience with nurse concern and caring (t = -2.054, p = .042). Adoption of a structured NLR has a significant impact on improving patient satisfaction in an oncology setting where patients receive care from many disciplines, such as surgical, medical, radiotherapy, and radiology. Efficient structured NLRs of nursing professionals are important for enhancing the quality of nursing care and patient satisfaction.

Teach-Back Method: Using a Nursing Education Intervention to Improve Discharge Instructions on an Adult Oncology Unit.

Transitions from acute clinical care to the outpatient setting can be daunting. Clear explanations of discharge instructions from nurses and assessment of the patient's understanding can have a positive impact. The purpose of this study was to assess the effect of an education intervention on nurses' use of the teach-back method, as well as the effects on patient satisfaction at discharge. The setting was a 20-bed adult oncology unit. Nurses' understanding of the teach-back method pre- and posteducation intervention was assessed using the Conviction and Confidence Scale. The effect of the intervention on patient satisfaction was assessed using the Press Ganey survey three months before and after teach-back education. The results of this study indicated that nurses were more confident in their ability to use the teach-back method and integrated many teach-back competencies into clinical practice. Although few follow-up surveys were received, longer-term data indicated continued improvement in patient satisfaction and understanding of discharge instructions.

Assessment of breast cancer treatment outcome at Tikur Anbessa Specialized Hospital Adult Oncology Unit, Addis Ababa, Ethiopia

Abstract Introduction: Breast cancer is a leading cause of death worldwide, and ranks as the fifth cause of death from all cancers, and the most common cause of cancer death in women in both developing and developed countries. However, information regarding treatment outcome of breast cancer is scarce in Ethiopia. Objective: The aim of this study was therefore to assess treatment outcome among breast cancer patients at Tikur Anbessa Specialized Hospital. Method: Hospital-based retrospective cross-sectional study was conducted. Data were collected by reviewing the medical records and by phone interview. Result: A total of 303 patients were included in the study, more than one-fourth (31.02%) of the patients were in the age range of 30–39 years, with a mean age of 42.10 years. More than half (54.10%) of the patients were diagnosed to have breast cancer with clinical tumor, nodal status, and metastasis stage III breast cancer. The frequently used combination chemotherapy was FAC (5-fluorouracil, doxorubicin, and cyclophosphamide) in 66.9% patients. At the end of 3 years treatment follow-up, 46.53% of patients were dead, 34.32% were alive. Logistic regression analysis showed that age (adjusted odds ratio [AOR] = 0.32; 95% confidence interval (CI): 0.12, 0.95; P = 0.040), chemotherapy cycle (AOR = 7.36; 95% CI: 2.28, 23.79; P = 0.001), stage of the disease (AOR = 0.11; 95% CI: 0.05, 0.29; P = 0.000), and endocrine therapy (AOR = 0.09; 95% CI: 0.04, 0.22; P = 0.000) were significantly associated with the outcome of death. Conclusion: Treatment outcome of breast cancer is poor and requires health education and sensitization on preventive.

Assessment of medication use process in adult oncology unit of Tikur Anbesa Specialized Hospital

Abstract Background: Chemotherapy errors affect several steps of medication-use process. A reduction of errors and toxicities, and an increase in error awareness, dose verification, proper documentation, and appropriateness of supportive care treatment are important. The present study was conducted to assess the medication-use process and dose-related errors in an outpatient adult oncology unit of Tikur Anbesa Specialized Hospital. Methods: An institutional-based cross-sectional study was conducted in an oncology outpatient adult oncology unit of Tikur Anbesa Specialized Hospital between May 1 and June 30, 2012. A total of 212 patient records for 583 chemotherapy administrations were reviewed during the study period. Results: The overall dose-related error rate was found to be 228 (39.1%). Specific rate of dose-related errors were (under dosing 58 (25.4%), overdosing 52 (22.8%), inaccurately reconstituted doses 106 (46.5%), and inappropriately adjusted doses 12 (5.3%). Dose labeling and documentation of appropriate time of administration for each chemotherapy preparation were not evident in the unit records. Only 3/14 dose verifications and 3 dose documentation processes were found. Supportive care treatment was not performed according to the recommended standards. Of the 23 equipment and supplies needed for chemotherapy preparation and administration, only 8 were available. Conclusions: The findings of our study indicate that the medication-use process in an outpatient adult oncology unit was below expected standards in 2012. The hospital and the school of pharmacy should give emphasis on the establishment of pharmacist run oncology pharmacy for chemotherapy preparation. Policies and guidelines for chemotherapy mixing and administration service and standardization of the process workflow should be developed.

EMERALD: Emergency visit audit of patients treated under medical oncology in a tertiary cancer center: Logical steps to decrease the burden.

Background:We are a tertiary care cancer center and have approximately 1000–1500 emergency visits by cancer patients undergoing treatment under the adult medical oncology unit each month. However, due to the lack of a systematic audit, we are unable to plan steps toward the improvement in quality of emergency services, and hence the audit was planned.Methods:All emergency visits under the adult medical oncology department in the month of July 2015 were audited. The cause of visit, the demographic details, cancer details, and chemotherapy status were obtained from the electronic medical records. The emergency visits were classified as avoidable or unavoidable. Descriptive statistics were performed. Reasons for avoidable emergency visits were sought.Results:Out of 1199 visits, 1168 visits were classifiable. Six hundred and ninety-six visits were classified as unavoidable (59.6%, 95% CI: 56.7–62.4), 386 visits were classified as probably avoidable visit (33.0%, 95% CI: 30.4–35.8) whereas the remaining 86 (7.4%, 95% CI: 6.0–9.01) were classified as absolutely avoidable. Two hundred and ninety-seven visits happened on weekends (25.6%) and 138 visits converted into an inpatient admission (11.9%). The factors associated with avoidable visits were curative intention of treatment (odds ratio - 2.49), discontinued chemotherapy status (risk ratio [RR] - 8.28), and private category file status (RR – 1.89).Conclusion:A proportion of visits to emergency services can be curtailed. Approximately one-fourth of patients are seen on weekends, and only about one-tenth of patients get admitted.