HOME     NURSING AFFAIRS     PATIENT RIGHTS     PATIENTS AFFAIRS

PATIENT CARE UNIT:

Scope of Service:

The Oncology Clinic provides treatment and supportive nursing care for adult and pediatric oncology/ hematology/ SCT and palliative care patients.

Services covered in this clinic include a Treatment centre where long and short chemotherapy varying from short IV push to infusions up to 9 hrs are administered as well as transfusions of blood and blood products. We have an extensive adult and pediatric bone marrow transplant team led by their respective coordinators (see attached scope of practice). We have a total of approximately 70 physician’s clinics per week including 8 combined clinics and 5 surgical-oncology clinics. We have three “drop in” nurse clinics (oncology/hematology, benign hematology and breast care) which are managed by experienced bilingual Clinic Coordinators and Staff Nurses (SN I) who triage the patients and work collaboratively with multidisciplinary team to manage patients problems.  The adult medical oncology section is divided under the following programs: Breast Cancer, Lymphoma, Sarcoma, Head and Neck, Lung, GI/ GU and Gynecology.  The adult Hematology/ SCT section is mainly divided under three programs, namely Stem Cell Transplant, Leukemia and Non-Neoplastic Hematology (also known as benign hematology)  .Pediatric Hematology/ Oncology/ SCT patients are mainly seen in KFCCC & R but we still see and treat patients in our consultant clinics, treatment areas and nurse clinics. The unit provides clinical rotation to Nursing Interns, Nursing Students, new Nursing Graduates and in partnership with HOBA and NER also provides training for nurses from other hospitals.

Monthly patient volume is approximately 5000. 

Frequent Procedures/Services/Functions:

The Treatment Areas provide a multitude of treatments, drug administrations and procedures including:

Ø                   Antineoplastic agents up to 9 hours duration,

Ø                   Blood and blood products transfusions,

Ø                   Immunoglobin,

Ø                   IV Antibiotics, IV Antifungal, IV Antivirals, IV Steroids, IV Chelating agents,

Ø                   TPN and IV Lipids,

Ø                   IV hydration,

Ø                   Peripheral Stem Cells Transplants,

Ø                   Donor Lymphocyte Infusion,

Ø                   Bone Marrow Aspiration and Transplantation,

Ø                   Lumbar punctures with and without intrathecal chemotherapy,

Ø                   Pentamidine treatments

Ø                   Minor Dressings

Ø                   Paracentesis

Health Educators, Doctors and Nurses provide information and education regarding chemotherapy and their side effects as well as management of Bone Marrow Transplantations.   Mammacare certified nurses provide support and education regarding breast self-exam and prosthesis fittings.  We also provide conscious sedation for painful procedures.

The Oncology Centre has its own phlebotomy service, an intravenous admixture pharmacy and an outpatient pharmacy.

Hours of Operation:

Sat -Tues:    0800 – 1800 hrs

Wednesday: 0800 – 1700 hrs

Each nurse has scheduled overtime one week every three months, which require a longer working day.  This is reimbursed as “comp time” or paid overtime.

CRITERIA FOR ADMISSION INTO SERVICE:

Patients must be approved for tertiary care after referral to oncology/hematology program through Medical Eligibility/Royal Order.

STAFFING PLAN: (When Fully Staffed)

1 Head Nurse

1 Breast Coordinator

1 Nursing Clinical Coordinator (Chemo Training / Charge Nurse)

1 Benign Hematology, Clinical Coordinator

1 Health Educator

28 Staff Nurse I

7 Staff Nurse II

2 Staff Nurse III

7 Ward Clerks

5 Patient Care Assistants

In addition to the above staff for the Oncology Clinic, the Stem Cell Transplant Clinics (SCT) are staffed separately by:

Most of the nurses providing support and care for patients in the physician clinics are female bilingual SN II and SN III.  In the treatment areas, the majority of nurses are Staff Nurse I.  The two nurses in the nurse “drop in” clinic are female, bilingual Staff Nurse I.  In addition to the above staff, the clinic is well supported by Pharmacists, Scheduling Clerks, and Social workers, Patient Relations Representative, Play Therapist, one Interpreter, IV Nurses, Respiratory Nurses and Nutritionist.

Method of Adjusting to Staffing Variances:

The nursing schedule for the staffing needs of the clinic is done every week on a Wednesday based on the projected number of patients in each clinic and the number of physicians for those clinics.  The schedule is made one week in advance and for the treatment areas it is based on a 6-week rotation to different areas of the clinic to promote multi skilling of staff. Staffing may be adjusted on a daily basis depending on the volume of patients in each area and operational requirements of the unit.

QUALIFICATION OF STAFF: Qualifications/Licenses/Certifications Required

Registered Nurses: (SN I, SN II, SN III)

1.       Registered Nurse License or registration from country of origin

2.       Oncology/ Hematology experience

3.       Mandatory KFSH & RC certified courses:

BCLS, Fire and Safety, Infection Control

Staff in the Treatment Areas are also required to have the following competencies:

·         Chemotherapy Certification

·         Conscious Sedation

·         Pediatric and Adult Physical Assessment

·         Competency in accessing central venous access devices and peripheral venous cannulation for both pediatric and adult patients.

·         Annual unit based competency skills

Ward Clerks:

1.                   Saudi national

2.                   English speaking

3.                   High school diploma required

Patient Care Assistants:

1.                   Saudi national

CONTINUING EDUCATION/ IN-SERVICES PROVIDED TO MAINTAIN STAFF COMPETENCY:

Continuing education is offered through staff development programs both coordinated by NER or at unit level. Education needs of staff are assessed by using education surveys and questionnaires, new treatment protocols, performance improvement activities, new products or equipment. An education plan is used to ensure educational needs are addressed and met.

Staff Meetings are held fortnightly and staff attendance is mandatory.  These meetings provide an opportunity for information sharing, discussion and addressing common issues such as AORs, re-enforcing hospital policies, etc.

In-services are scheduled for every alternate week and are provided by staff nurses, clinical instructor, physicians and guest speakers. 

An educational oncology web page in Arabic has recently been made operational through the King Faisal homepage and hopefully this new site will be a helpful resource to cancer patients, their families and healthcare professionals who are involved in the care of cancer patients.

There is also a charge nurse who is assisted by a clinical instructor covering Oncology clinic as part of Ambulatory care nursing, who facilitates educational requirements of the nursing staff, e.g. competency check-off, mandatory courses and general skills lab.

METHODS OF COMMUNICATION WITH OTHER DEPARTMENTS:

Internal and External Methods of Communication

Internally, direct communication between physicians, head nurse, charge nurse, nurses, pharmacists, phlebotomists and other support staff occurs throughout the day.  A communication folder provides all relevant and recent minutes of meetings, memos, etc. 

Important information for immediate attention is posted on notice boards.  Person to person or small group meetings also occur.

Externally, the Head Nurse collaborates with other services or departments, via committees, meetings, telephone call, e-mail, memos or speed letters and staff members usually communicate by telephone.

A collaborative meeting with each specialty is held at least every two months and clinic nurse coordinators are encouraged to attend.  Interdisciplinary physician meetings are held monthly and can be attended by nurses as workload permits.

Collaborative Relationships with Other Departments:

The Oncology Centre strives to maintain productive and open communication with all departments.  We work collaborative with areas that service our patient groups, particularly CCC, DMU, B1, B3-II, F3, F2-2, E3, E1, Radiation Therapy, Home Health Care, EMS, Medical Records, Appointments, Blood Bank and the Lab. 

DISCHARGE CRITERIA:

Discharge from the system is determined by collaboration between the medical staff and eligibility based on the status of the patients diagnosis and prognosis.

                                   [ Home ] [ Up ] [ NEWS ] [ Divisions ] [ Phone Directory ] [ Score Cards ] [ ACN Committees ]