In cases where cancer patients fail to respond or develop tolerance to opioids, conversion to methadone is a reasonable approach. Although equianalgesic tables may not always predict final methadone doses, when properly selected can be useful tools for the experienced clinician. A customised and cautious approach is thus advisable when rotating to oral methadone, especially in patients who have experienced opioid toxicity.
Method One-hundred and one patients with HPB cancer were supported by integrated ESC delivered within a co-located clinic structure. Data relating to symptoms and quality of life were collected prospectively. Survival data and chemotherapy usage was retrospectively analysed following minimum followup, utilising a matched control technique. Results ESC patients illustrated improvements in certain key symptoms including pain, nausea, vomiting and mood over time. Patients also had less aggressive treatment towards the end of life amounting to 31% less chemotherapy than controls with comparable survival. Conclusion An integrated nurse-led ESC model can be effective in improving outcomes for patients with HPB cancer. This model resulted in improved quality of life and a reduction in the amount of chemotherapy administered in the last year of life with comparable survival.
Conclusion High fidelity simulation training for registered nurses in an acute hospital is an effective way to teach palliative/end of life care skills. Registered nurses are keen for simulation training to be integrated into end of life care education.
Conclusion High fidelity simulation training for registered nurses in an acute hospital is an effective way to teach palliative/end of life care skills. Registered nurses are keen for simulation training to be integrated into end of life care education.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.