Catherine Barnett

Patients' satisfaction with fast-track surgery in gynaecological oncology.

This study investigates the experience and satisfaction with care of fast-tracked gynaecological patients. The Sydney Gynaecological Oncology Group, New South Wales, Australia, has previously shown the benefits of a fast-track surgery programme for gynaecology patients with both complex benign gynaecological pathology and gynaecological malignancy. The question of whether these benefits translate into a positive experience for fast-tracked patients, in the context of their hospital stay and healthcare team care, has not been previously explored in detail. A self-administered satisfaction questionnaire incorporating the European Organisation for Research and Treatment of Cancer (EORTC) cancer in-patient satisfaction with care measure (INPATSAT-32) questionnaire with additional questions was administered to 106 gynaecology participants at Royal Prince Alfred Hospital. Participants reported high levels of satisfaction with patient care and support received from doctors, ward nurses and the hospital as a service and care organisation, within the context of a fast-track surgical programme. Early hospital discharge after gynaecological surgery results in both enhanced recovery after surgery (ERAS) and high levels of patient satisfaction.

Patients' perspectives of fast-track surgery and the role of the fast-track clinical nurse consultant in gynecological oncology.

This study examines the role of the fast-track nurse in gynecology from a patient perspective. The fast-track nurse is a specialist nursing role, which coordinates patient care, in addition to providing specialized clinical care. Semistructured interviews were conducted with women who had fast-track surgery for gynecological cancer.

The road less travelled: Australian women's experiences with vulval cancer

Despite advances in surgical treatments and the availability of more conservative treatment options, women treated for vulval cancer still experience significant complications such as urinary incontinence, lymphoedema, pruritus, sexual and intimacy issues. These issues can profoundly impact a womans quality of life. The subjective experience of women diagnosed and treated for vulval cancer in the literature is limited, possibly due to its comparable rarity to other gynaecological and female cancers and because it was traditionally seen mainly in the elderly female population. Nonetheless, younger women are also being diagnosed with vulval cancer. This paper reports the findings from a qualitative study about twelve womens experiences with vulval cancer from diagnosis, through treatment and recovery. Womens feelings of isolation, their unmet information and support needs, physical concerns arising from vulval cancer, particularly after surgery, and the consequences for their body image and intimate relationships with partners, were highlighted within the data. The central findings from this study emphasise the need for further research to develop appropriate interventions for women with vulval cancer. It also highlights opportunities to improve clinical practice into the supportive care of women with this isolating disease.

Nurse confidence in gynaecological oncology practice and the evaluation of a professional development module

Background: A tertiary-based education program on gynaecological oncology was attended by 62 registered nurses (RN). Aims: The program aimed to update nurses’ knowledge, improve skills and ability to manage common situations and to assess program efficacy. Design: Evaluation framework with specifically designed pre-post questionnaire about program content and nurse confidence. Method: RN interested in gynaecological oncology were invited to attend. Nurses rated their confidence about gynaecological oncology skills one week prior to the program, immediately post-course, 3 months post and 12 months post. Speaker presentations were evaluated immediately post-course. Results: Participants indicated improved confidence immediately after participating in the course (z = −6.515, p < .001); whilst confidence subsequently declined and stabilised up to 12 months post-course, it still remained significantly higher than before the course: 3 months post- (z = −5.284, p < .001) and 12 months post- (z = −4.155, p < .001). Conclusions: Results support the value of continuing professional education for improving nurse confidence in the gynaecological oncology setting.

Hospital-acquired pressure injuries: Are they accurately reported? A prospective descriptive study in a large tertiary hospital in Australia

AIM The aim of this study was to (1) examine the reasons for the increased incidence of hospital-acquired pressure injuries (HAPIs) reported in the Incident Information Management System (IIMS), and (2) gain feedback from nurses regarding HAPI being reported in the IIMS at one tertiary hospital in Australia. MATERIALS AND METHODS This prospective descriptive study included a review of patients with a reported HAPI from July 2015 to June 2016. Patient assessment and semi-structured interviews with nurses were conducted. Interview data were anonymised and content thematically analysed. RESULTS Data were collected on 417 patients who were reported to have a HAPI; of these, 363 patients were clinically assessed. 69.7% (253/363) were inaccurately reported in the IIMS, based on stage, location, not a true pressure injury or not hospital-acquired. A high number of patients (176/363, 48.5%) were found to have various skin conditions that were not HAPIs. Three themes were identified from the interviews: (1) meeting the mandated reporting requirements; (2) incident reporting and communication; (3) difficulties documenting aetiology. CONCLUSION This study identified inaccuracies in diagnosing, classifying and reporting pressure injuries. Nurses described barriers and challenges to classifying and reporting HAPIs. Inaccurate reporting can lead to incorrect conclusions especially when reported data alone is relied upon for patient treatment, benchmarking and analysis. Guidelines are needed at a national and international level to support the quality of clinical assessment, reporting and documentation. Findings from this study have led to a new approach to patient assessment and to minimise errors in incident reporting at this organisation.