Malignant spinal cord compression: a retrospective audit of clinical practice at a UK regional cancer centre

Malignant Spinal Cord Compression (MSCC) is a particularly challenging area of cancer care where early diagnosis and expert multiprofessional care and rehabilitation, are paramount in optimising quality of life. This audit reports data collected retrospectively over a period of 12 months on patients with MSCC referred to the West of Scotland Cancer Centre (n=174). It was carried out to build on the work of the Clinical Resource and Audit Group (CRAG) and to examine current practice for symptom assessment, multiprofessional care and rehabilitation of patients with MSCC admitted to the cancer centre. Areas of concern include poor assessment of pain, the poor ambulatory status of patients on admission and the lack of clear plans for mobilisation and rehabilitation for the majority of patients. Recommendations include the development of regional guidelines for referral, treatment and rehabilitation, and the development of a pathway of care for use in all care settings across the region, together with improvements for use in patient information, staff education, audit and research. These are now being taken forward through the West of Scotland Cancer Network with dedicated funding from Macmillan Cancer Relief

Violence and psychosocial safety climate; quantitative and qualitative evidence in the healthcare industry

Occupational violence is a psychosocial hazard of increasing concern, and healthcare has been identified as a ‘high risk’ industry, reinforcing the question:‘Who cares for the carers?’ Psychosocial safety climate (PSC) is a leading predictor of other risks to psychological health including psychological demands and workplace violence. We investigate how PSC is related to violence in the healthcare industry, via the extended psychological health erosion process. We use quantitative data from 288 frontline healthcare workers in Australia (across 26 teams) to conduct a multilevel analysis. Qualitative data from interviews with 27 workers also aid in contextualising the findings. We find that healthcare teams with poor PSC are also more exposed to occupational violence, report increased musculoskeletal pain, and ultimately higher work injury. Identifying the means to improve PSC in a healthcare setting is an opportunity to enhance the wellbeing of workers and their role in the provision of quality care