Survivorship Care Plans (SCPs) are an element of quality survivorship care.1 Several reports2 and guidelines3 recommend SCPs at end of cancer treatment as a standard of care. SCPs are personalised records of the care that outline follow-up (FU) surveillance, long-term symptoms, signs of recurrence, community resources and lifestyle modifications to reduce late effect risks.4 SCPs help survivors as...

Researchers have demonstrated that anthracycline and taxane regimen reduce mortality by a third compared with no chemotherapy in early breast cancer, independently of tumour characteristics.1 A previous report suggested that dose-intensification strategies including chemotherapy administration every 2 weeks or giving higher dose of drugs sequentially rather than...

Obesity influences the development, prognosis and mortality rates of many types of cancer including that of the breast.1 Research correlates weight gain in adulthood with an increased risk of breast cancer.2 The International Agency for Research on Cancer contends that the relationship between intentional weight loss and cancer risk is yet to be determined.1 Winder and colleagues3 suggest that bariatric surgery (an intentional weight loss...

Direct current cardioversion is an electrical cardiac treatment used to reset heart rhythms in some patients with atrial fibrillation.1 While direct current cardioversion had historically been medically led, increased demand for the treatment has led to the development of nurse-led services.2 Nurse and nurse practitioner led cardioversion clinics will be seen more often as our populations age. It is important to...

The introduction of early warning scores and rapid responses is associated with improvements in patient outcomes such as cardiopulmonary arrests in general wards, unplanned intensive care unit (ICU) admissions and mortality.1 Internationally, systems enhancing patient safety and reducing risk of adverse events are part of quality measures embedded in organisations.1–3 Douw et al’s systematic review finds nurses’ judgement and intuition in assessing patient signs and symptoms are...

Patients with cardioembolic stroke and non-valvular atrial fibrillation are at a high risk of early stroke recurrence.1 Oral anticoagulation therapy (OAC) in the form of vitamin K antagonists (VKAs) and non–vitamin-K oral anticoagulants (NOACs) are the medical therapy of choice in the secondary prevention of stroke. American Stroke guidelines2 recommend the initiation...

As prevalence of multiple chronic conditions (MCC) increases, financial, personal and institutional burdens will rise.1 Complexities require more information on polypharmacy, disease management and assessments of impact on service provision.2 This qualitative study3 evaluates how patients cope with their diagnoses and manage their own symptoms. It offers a cultural perspective on the burdens of chronic disease management and presents guidance on coping strategies used in Chinese...

Inflammatory bowel disease (IBD) is a chronic condition of the gastrointestinal tract that is associated with embarrassing signs and symptoms that include rectal bleeding, diarrhoea, faecal urgency and abdominal pain. Byron et al have provided a meta-synthesis of patients experiences with this condition1 and an update on previous work conducted by Kemp et al.2 The authors...

Advance care planning is largely derived from Western countries,1 with a reliance on Western concepts of autonomy and decision making.2 Much advance care planning research is from the USA, UK and Europe,3 despite significant international cultural differences in the concept of autonomy and decision making.4 5 Lin et al’s1...

Functional decline is prevalent among older patients who have been hospitalised. During an acute hospitalisation, there may be significant functional decline with non-disabling (and disabling) conditions causing new disability.1 Decline often persists after discharge...

Chronic breathlessness,1 is a major cause of suffering in people with severe disease. Treatment includes cardiorespiratory rehabilitation training, supplemental oxygen in hypoxaemia and low dose opioids in selected patients, but is often insufficient and new therapeutic options are needed.2

Airflow directed at the face using a fan or at the nasal mucosa...

The use of early warning scoring tools plays an important role in the identification and management of patients at risk of deterioration1 in acute and non-acute settings.

However, the use of such tools in the practice setting and especially in non-acute settings, such as...

Little is known about the process of living well with advanced cancer or how to support it.1 The study addresses this by collating the experiences of people living with advanced cancer and comparing them with the ‘Theory of Living Well with Chronic Illness’.2 The authors were familiar with the...

Previous research on delirium prevalence in hospital settings suggests it is a common condition which can affect around 20% of older people.1 Although delirium is both preventable and treatable, healthcare professionals often lack the necessary knowledge and skills regarding delirium prevention, identification and management.2 This has led to high rates of undiagnosed delirium, estimated to be as high as...

Delirium is a syndrome characterised by an acute onset of disturbed consciousness, cognitive function or perception. It is associated with higher mortality, increased rates of dementia and longer hospital stays.1 Consequently, establishing methods of prevention has been identified as an important goal.1 Delirium is a common issue, affecting one-third of hospitalised general medical patients aged 70 and over.2 Campbell et...

AF occurs frequently and leads to a higher incidence of thromboembolic events and stroke. Therefore, OACs are crucial and recommended. This therapy can be carried out with vitamin K antagonists (VKAs) or non-VKA OAC (NOACs). Both have demonstrated a significant reduction in the risk of thromboembolic events. Additionally, an effective rhythm control strategy, the catheter ablation, is useful and reduces the...

PIVCs are the most common invasive procedure with each patient receiving an average of two PIVCs during their admission.1 This common device, however, increases risk for BSI/CRBSI with a mortality rate of 12%–25%.2 Many institutions disagree on what best practice recommendations should be. Many institutions including the Centers for Disease Control support the routine removal of PIVCs as a method to decrease the risk...

Breast cancer is reported to be the most common type of cancer in women.1 There are distinct histological subtypes; luminal A, luminal B, basal-like and human epidermal growth factor receptor 2 (HER2) enriched.2 Improved molecular understanding has facilitated the development of targeted treatments. Disease stage and...

Guidelines for managing patients with heart failure indicate that discussions about the condition, treatment options and advance care planning should be discussed at an early stage of the disease.1 Prior to implanting a cardiac device, clinicians should be discussing when device deactivation might become appropriate.2–4...

COPD is a long-term, debilitating, respiratory condition that impacts the lives of millions of people worldwide. Poor management of COPD can lead to hospital admissions, increased healthcare costs and poorer outcomes for patients and their families.1 A range of interventions are...