The academic setting provides diverse opportunities for research, education, professional development, and evidence-based practice, while providing clinically challenging care. Nursing care is improved by on-going evaluation, continued education and research. We ensure the highest standard of service at the forefront of research, teaching and skilled specialties within available resources.

Education

Specialist Course on Cancer Nursing

The program jointly conducted by the Chinese University of Hong Kong, Department of Clinical Oncology and the Department of Pediatric has been run for 5 intakes and 187 nurses were graduated.

The aim of this course is to promote cancer nursing as a specialized discipline in Hong Kong, and empower nursing staff with

• Thorough grounding in the theory and practice of oncology nursing care,
• Skills necessary for effective communication with patients, their families and other colleagues,
• Ability to integrate knowledge and skills into their work and to perform effectively as health educators to the benefit of both patients and community.

In-hourse Training

Apheresis Course For Nurses
The course is to prepare nurses with a sound theoretical base for running of the apheresis machine, a rational basis for the use of apheresis procedures in selected disease states and a thorough practical training including setting up and priming the machine, and to provide demonstrations by skilled operators and supervised experience on patients leading to proficiency in the clinical setting.

Chemotherapy Administration Course for Nurses
The course is to prepare nurses for administration of intravenous chemotherapy safely and competently.

Training Course On Venipuncture
The course is to prepare nurses to collect blood specimen properly and safely.

Overseas Training

With generous support from the hospital, the Chinese University of Hong Kong, Department of Clinical Oncology, and outside organizations, many tremendous opportunities of overseas training have been made available to oncology nurses. The courses that nurses have been trained overseas includes Bone Marrow Transplant course, Management Placement in a Hospice Unit in UK, Radiotherapy Nursing Course, Chemotherapy Administration Course, Palliative Care Workshop, Lymphedema and Complex Physical Therapy, Pain Management Clinical Placement.

Preceptorship Progrogramme

The programme is targeted to help the new coming nurses to adapt their role and the environment in the clinical setting. All new staff will be preceptored for three months and evaluated at the end of the programme with requirement of achieving the specific skill and knowledge.

In-service Continuing Education

We carried out in-service education programs such as the scheduled talks and periodical Nursing Journal Club based on a review of the cancer nursing literature and a survey of nursing staff needs for continuing education. The oncology nursing staff and the interdisciplinary team are involved to participate in setting topics, preparation and delivery of program.

The topics of the Nursing Journal Club cover most of areas related to cancer care and the information about coming topic will be posted in the department. The presented topics include

• Use of Fentanyl patch in cancer patients,
• Wound bed preparation & wound care product,
• Side-effect of Opioids: Morphine, Methadone, Fentanyl patch & Nursing Care,
• Hypercalcemia-- Nursing Management,
• Pain Assessment & Practice in Different Setting,
• Hormonal Treatment in Breast Cancer,
• Contraception issues in cancer patient,
• Nutrition in cancer patient,
• Management & Care of Patients on Docetaxel Treatment,
• Lymphedema Care & Management,
• Traditional Chinese Medicine for Cancer Patients.

Conference

List of previous Nursing Conferences organized by the Department of Clinical Oncology

Coming Nursing Conference

The Third Pan-Pacific Nursing Conference and,

The Fifth Hong Kong Nursing Symposium on Cancer Care
11th –12th November 2005
Excellence in Nursing Practice Innovation and Creativity

Jointly organized with the Nethersole School of Nursing, CUHK,
School of Nursing, Fudan University,
School of Nursing, The Hong Kong Polytechnic University,
Department of Nursing Studies, The University of Hong Kong

Symposium Objectives

• To provide a forum for oncology nurses to exchange and learn the latest information about cancer care from a worldwide perspective.
• To promote the implementation of evidence based practice in cancer care.
• To promote a renewed sense of personal commitment to cancer care through networking and collaboration.

Website: http://www.cuhk.edu.hk/med/nur
Email: pancon@cuhk.edu.hk

Research

We support cancer care through evidence-based practice and clinical research studies, by initiating and supporting clinical cancer trials and supportive care research through grants, and collaboration with the Comprehensive Cancer Trials Unit and expertise of other members of multi-professional team. The nurses collaborate with the various principal investigators and members of the CCTU research team in the planning, implementation, and facilitation of investigational studies

We have obtained research funding from the Hong Kong Government to carry out studies on the dressing treatment for irradiation wound in NPC and lymphedema in breast cancer patients undergoing axillary lymph node dissection. We have conducted some research projects about the nurse-administered chemotherapy service evaluation and patient information needs, and have developed phase III randomized control trials of dressings on radiation-induced wound. We have also been involved in some research projects about nurse-administered interventions to improve the treatment-induced complications, such as progressive muscle relaxation in managing chemotherapy-induced nausea and vomiting, implementation of mucositis guidelines in relieving patient mucositis.

Acute Care Inpatient Units

We have 2 wards with 66 beds. Ward 4E and 4F is a 24 hour, inpatient adult oncology unit, serving for patients who are admitted for chemotherapy, radiation therapy, radiological and/or diagnostic procedures, post surgical care, treatment for complications and terminal care. The inpatient unit has five double door rooms with positive air pressure and high-efficiency particulate air (HEAP) filtration to accommodate neutropenic patients. The delivery of nursing care is based on a Team Nursing Model. A charge nurse is assigned on each shift and is responsible for the daily assignment of patient care for a designated cluster of patients. Patient care assignments are evaluated at the beginning of each shift and adjusted throughout the shift for patient acuity by the charge nurse, in working with the team of nurses. They provide direct patient care, patient education, and psychosocial support; perform or assist with basic procedures in accordance with infection control principles and safety policies; and respond to patient needs in a cost effective manner.

Ambulatory Clinics

The ambulatory clinics are located at three distinct clinical areas - the basement of Li Ka Shing Specialist Clinic, the ground floor and 1st floor of Cancer Center where initial consultation, preoperative/ postoperative consultation, follow-up and supportive care are provided to patients with various diseases of cancer exclusive of those receiving radiotherapy and chemotherapy. Operational hours of Out-patient Department are Monday through Friday, 9 a.m.-5 p.m. and Saturday, 9 a.m.-1 p.m., with scheduled time for specific clinic. The model of nursing practice for the clinics is based upon team nursing. Intrinsic to this model is the formation of a collaborative relationship between the different levels of nursing staff in which they share responsibility for a caseload of patients. The team of nurse works with the physician and provides continuity of care.

Chemotherapy Day Ward

The Chemotherapy Day Ward is located on the 1st floor of Cancer Center. It opens on Monday through Friday, 9 a.m.-7 p.m. and Saturday, 9 a.m.-1 p.m. The Chemotherapy Day Ward consists of a reception, a waiting area, a clinical workstation, 12 beds, 18 treatment armchairs, 2 rooms for chemotherapy administration. It provides services including chemotherapy infusion, IV hydration, administration of blood products, antibiotics, diagnostic test, apheresis and treatment so they are better able to manage illness, side effects and course of treatment. The specialist nurses with Certification administer cancer chemotherapy in accordance with agency policies and procedures; and perform venous cannulation. The nursing practice model is based upon the team nursing model. Inherent in this model is the formation of a collaborative relationship amongst the different levels of nursing staff within each practice. The charge nurse and other nursing staff assume responsibility for the functioning of the unit.

Radiotherapy Section

The Radiotherapy Section consisting of Planning, Simulation, Treatment and Brachytherapy Areas is located at the basement of Li Ka Shing Specialist Clinic where care is provided to hospitalized and ambulatory patients receiving radiation therapy. Adult and pediatric patients are treated in the unit. The hours of operation are Monday to Friday, 9 a.m.-5 p.m. and Saturday, 9 a.m.-1 p.m., with hours extended as needed to accommodate increased patient activity. The nursing practice model in the unit is based upon a collaborative practice model. The nurse and the radiographers and the radiation oncologist share responsibility for a caseload of patients. The nurses in Treatment Clinic and Planning Section work with the physician and radiographers, collaborate with Radiotherapy Nurse Clinic, and provide continuity of care during daily treatment visits, at home and during hospitalization, so patients are better able to manage illness, side effects and course of treatment.

Operation Theatre

The Operation Theatre is located at the basement of Li Ka Shing Specialist Clinic. It includes a procedure room, an operating room, and a recovery area. About 15 to 20 brachytherapy procedures are performed a month. These include high dose rate vaginal, cervical, nasopharyngeal, endobronchial and prostate brachytherapy procedures. The nursing practice model in Operation Theatre is based upon a collaborative model. The nurses coordinate the preparation of the necessary equipment, instrument and source used for each session of afterloading and implantation, and work with the physicist, radiographers, anaesthetist and physician to ensure the smoothness and safety of operation in accordance with the Infection Control Policies and Radiological Protection Rules.

Oncological Complication Care

Oncological complications occur in patients with cancer at any time during the course of the disease and carry a significant risk of death and must be treated immediately. These complications include disseminated intravascular coagulation, hypercalcemia, malignant pleural effusion, neoplastic cardiac tamponade, neutropenic infection, spinal cord compression, superior vena cava syndrome, syndrome of inappropriate antidiuretic hormone secretion and thrombosis. All the frequently used methods of cancer treatment – surgery, chemotherapy, radiation therapy and biotherapy – produce adverse effects on fatigue, nutrition, pain, breakdown of protective mechanisms, psychosocial issues, sexual function that can impair a patient’s physical, mental and social functioning.

The provision of quality oncological complication care requires a multidisciplinary team of professionals. Oncology nurses are on the frontlines of the provision of quality cancer care and each day they utilize highly specialized skills to coordinate and administer the comprehensive supportive care. Specifically nurses play an essential role in monitoring and managing oncological complications and side effects, stabilizing patients during an emergency, and documenting important information in patient charts.
We collectively have led many initiatives that have resulted in attention to concerns such as pain, fatigue, sexuality, fertility, family coping, long-term sequela of treatment, and numerous other areas pertaining to survivorship. Nurse-led clinics have been developed to address the physical burdens associated with cancer survivorship, with key focus on short- and long term sequela of treatment.

Radiotherapy Nurse Clinic

• Nurse who specializes in radiation therapy and the associated reactions that are expected during and after treatments provides clinical support, intervention, patient education, and continuity of patient care.

Lymphedema Clinic

• Nurse who specializes in lymphedema care provides patient education, monitoring, complex physical therapy in preventing, treating, and controlling secondary lymphedema.

Oncology Wound Clinic

• Nurse who specializes in oncology wound care provides intervention, patient education and continuity of care to patients with post-irradiation wound, malignant wosund, extravasation wound and unhealed surgical wound that may retard the cancer treatment, and provides clinical support and advice in response to the consultation from other unit or facility.

Pain and Palliative Care

Inadequate pain control and palliative care may be due to failure to acknowledge the existence and severity of pain, inadequate assessment of pain, incorrect use of treatment modalities or failure to deal with the psycho-social and spiritual aspects adequately. While in the disease-focused model of care in acute setting, there may be little emphasis on the individuality of the patient and the relationship between healthcare professional and patient. We are working out ways to improve our services and methods of care delivery model.

To provide quality pain and palliative care, the team nurse uses three guiding principles: autonomy/ choice, advocacy and acceptance to best meet the goal of supporting an individualized dying experience. We recognize that a change in the patient’s physical, functional, interpersonal or spiritual well-being affects the status of all dimensions of well-being. We collaborate with the Bradbury Hospice and Shatin Hospital to provide continuous care through their in-patient service and home care by the Bradbury Hospice Home Care Team and Shatin Hospital Support Team. The interdisciplinary team care nurses work together to prevent and/ or minimize suffering, thus allowing patient and family to attend to other dimensions of well-being, spirituality and life closure.

Nurses are provided with information about pain, pain assessment and pain management, and that knowledge is applied in practice. Patients are monitored regularly if they have pain. Their responses are documented and are recorded on the Pain Assessment Chart. We are also involved in patient and family education concerning topics such as personal care, administration of medications, use of equipment, catheter care, nutrition, skin care, nutrition and assistance with activities of daily living. Nurse educates the family about changes to expect, stages of disease and interventions to decrease suffering, physical as well as psychosocial and spiritual.

Conference and Symposium