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 LNR Quick Screen

 

 The East Midlands LNR Local Cancer Network: Psychological Support Services Implementation Group

 

In 2007 a working group was formed to look at the Network wide implementation of a simple screening tool for distress and associated problems. The aim is to enable level 2 staff (front line cancer specialists) to receive training and resources necessary to detect and manage distress at a basic level. All staff (level 1) should also be aware of distress and should seek advice from more experienced colleagues where required. The group have put in place in a series of level 2 training days for 2009 and a leaflet is being distributed to level 1 staff.

 

 A. PALLIATIVE CARE SUB-GROUP MEMBERSHIP

 

Addy Hackett

AH

Consultant Clinical Psychologist/Lead Psychologist for Northamptonshire Palliative Care Services

Alison Noble

AN

Macmillan Nurse Specialist Community Team, LCPCT

Angela Howe

AH

Operational Business Manager, Northamptonshire Palliative Care Services

Annie Jones

AJ

Macmillan Clinical Psychologist, NGH

Carolyn Ginns

CS

Head of Nursing Clinical Services/Lead Cancer Nurse, KGH

Chris Birtwisle

CB

Practice Development Nurse, LOROS

Chris Coggan

CG

Clinical Nurse Specialist in Psycho-Oncology, LPT

Dr Alex Mitchell

AM

Consultant Liaison Psychiatrist, LPT

Dr Anita Farrell

AF

Head of Service, Clinical Health Psychology, NGH

Jo Herdman

JH

Psychologist, UHL

Jo Kavanagh (Chair)

JK

Nurse Director, East Midlands Cancer Network

Lee Miller

LM

Gynaecology/Oncology Clinical Nurse Specialist, KGH

Liz Summers

LS

Cancer Lead Nurse/Oncology Nurse Consultant, NGH

Margot Emery

ME

Head of Nursing/Lead Nurse Cancer Centre, UHL

Maureen Abbott

MA

Breast Care Nurse, UHL

Pat Copson

PC

Senior Macmillan Nurse, LCRPCT

Sally Farrow

SF

Ward Manager Haematology/Deputy Lead Cancer Nurse, KGH

Sue Orgill

SO

Breast Care Nurse Specialist, UHL

Sue Todd

ST

Clinical Nurse Specialist in Psycho-Oncology, LPT

Trish Hughes

TH

Macmillan Haematology Clinical Nurse Specialist, NGH

 

 B. SCREENING INSTRUMENT

 

  

 

PDF Version

 

C. PILOT EVALUATION (Presented at IPOS09)

 

 

Background

 We report on a pilot phase of a large scale DT based screening programme (problem list) that examines the influence upon clinical practice for cancer health professionals. We tested the instrument on three sites.

 

Methods

The screen comprised DT, locally adapted and inbuilt audit associated help offered and clinicians judgement

 

We received 84 returns from 3x hospitals with a mean DT score of 4.5. Using a custom problem list there were 230 problems of which anxiety & family issues were most common. These can be considered individuals with unmet need.

 

Results

Clinicians gave help to 54% of those with unmet need but did not respond in 26%. No help was required in 15%.

 

Clinicians were unsure about a diagnosis in 19% of cases and in all of these situations the screen informed clinical judgement. As a proportion of all cases the screen informed clinician judgement in 30% and did not influence clinician judgement in 40%. The patient was well before and after screen in 15.5%. 2x2 judgement pre-post screen is illustrated (table).

 

Comparison with Pre Tool (Pre-post change)

 

 

Clinician thinks patient is distressed post-tool

Clinician thinks patient is well post-tool

total

Clinician thinks patient is distressed pre-tool

(or is unsure)

43

10

53

Clinician thinks patient is well pre-tool

7

24

31

 

50

34

   84

 

Conclusion

This pilot data suggest a simple screening programme can be implemented network wide. Some evidence suggests that the tool can positively influence clinical practice particularly in cases where the clinicians in unsure about a diagnosis pre-screen. However clinical opinion is only changes in a minority (30%) of cases and help is only offered in about half of those identified.

 

D. FUTURE PLANS

 

 Please go to www.psycho-oncology.info/screen2.htm

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