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Ambulatory approach to cancer care. Part 2: the role of nurses and the multidisciplinary team and safety

28 February 2019
Ambulatory Care
02 February 2019
Volume 28 · Issue 4

Abstract

Ambulatory care (AC) involves providing inpatient chemotherapy and supportive care as an outpatient service. Nurses and the multidisciplinary team (MDT) have a major role in this. AC at a major London teaching hospital trust is a nurse-led service, headed by specialist cancer nurses with excellent knowledge of the needs and priorities of patients undergoing intensive treatment. An experienced MDT, including administrative support, maintains safety and continuity of care. The nurses, MDT and patient work closely to promote the patient's wellbeing, self-management and trust. A scenario is analysed in this article to illustrate potential concerns around a patient's safety and suitability for AC. This is the second article of a three-part series; the previous article discussed AC at a major London teaching hospital and improving the patient experience.

Ambulatory care (AC) at a London teaching hospital is a nurse-led service that requires the support from a multidisciplinary team (MDT) comprising medical teams (junior doctors and consultants), pharmacists, healthcare assistants (HCAs), administrators, and clinical nurse specialists (CNS) to champion the service so it flourishes. A team of specialist nurses and a collaborative MDT are needed to promote communication for fostering safety, continuity and efficiency within the service and for patients (Jain et al, 2016). Nurses and the MDT are therefore vital in the set-up and running of AC to identify challenges, develop plans to address them and achieve common goals (Jain, 2016).

In an AC service, the job roles of nurses, pharmacists and doctors/specialty registrars (SpRs) are similar to their traditional inpatient equivalents. However, there is a diversification in responsibilities, leading to better and more autonomous decision-making in patient care.

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Ambulatory care
Chemotherapy
Outpatient
Patient care
Multidisciplinary communication