Fritsch, Robin, CRNP

Sikora, Barbara, LPN

Toman, Stefanie, CRNP

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineThe Impact of a Home-Based Palliative MedicineService on the Care for a Community-DwellingPatient with Intractable Cancer PainStefanie Toman CRNPLehigh Valley Health Network, Stefanie.Toman@lvhn.orgRobin Fritsch CRNPLehigh Valley Health Network, Robin_M.Fritsch@lvhn.orgBarbara Sikora LPNLehigh Valley Health Network, Barbara.Sikora@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/medicinePart of the Medical Sciences Commons, and the Nursing CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtToman, S., Fritsch, R. & Sikora, B. (2014, September, 18). The Impact of a Home-Based Palliative Medicine Service on the Care for aCommunity-Dwelling Patient with Intractable Cancer Pain. Poster session presented at the Cleveland Clinic 17th International PalliativeMedicine Symposium, Las Vegas, NV.© 2014 Lehigh Valley Health Network Patient Information•	 	53	year	old	male		•	 	Significant	other	only	family	support•	Unemployed•	 	UninsuredOutcomesDisease Progression and Treatment•	 	Diagnosis:	T3N1	poorly	differentiated	small	cell	carcinoma•	 	Multiple	rounds	of	chemotherapy	and	radiation•	 	Low	anterior	resection	with	loop	ileostomy•	 	Metastases	to	lymph	nodes	&	pre-sacral	soft	tissue•	 	Intractable	pain,	weight	loss,	functional	decline•	 	Malignant	bowel	obstruction•	 	Unsuccessful	pain	management	interventions	Major Challenges•	 	Patient	wanted	to	explore	all	options,	but	did	not	qualify	for	any	clinical	trial•	 	Poor	response	to	pain	management	interventions•	 	Patient	unwilling	to	accept	any	treatment	externally	visible	on	the	body•	 	Psychosocial	issues•	Lack	of	resourcesPalliative MedicineNurse Practitioner Role•	 	Care	coordination•	 	Provider	to	provider	communication•	 	Symptom	managementOutcomes•	 	Successful	pain	control	•	 	Patient	died	at	home	with	significant	other	as	per	patient	goals•	 	Significant	other	identified	tangible	benefit	of	Palliative	Medicine	involvementLearnings•	 	Care	coordination	a	multidisciplinary	effort	•	 	Importance	of	peer	consultation•	 	CRNP	house	calls	allow	therapeutic	relationship	building	and	promote	goals	clarification•	 	Importance	of	assessing	individual	patient	response	to	treatment	interventions•	 	Uncovering	psychosocial	needs•	 	Psychosocial	support	•	 	Advocacy	&	referral•	 	Transition	to	hospiceInterdisciplinary Care TeamLehigh Valley Health Network, Allentown, PAThe Impact of a Home-Based Palliative Medicine Service on the Care for a Community-Dwelling Patient with Intractable Cancer PainSample:Stefanie Toman, CRNP, Robin Fritsch, CRNP and Barbara Sikora, LPNPalliative Medicine TeamNurse Practitioner (CRNP)Social Worker (LSW)Clinical Coordinator (LPN)Patient& FamilyHomecarePainManagementOncology SurgeryPrimaryCareHospiceCitation of Honor Winner

The Impact of a Home-Based Palliative Medicine Service on the Care for a Community-Dwelling Patient with Intractable Cancer Pain

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1489&context=medicine

The Impact of a Home-Based Palliative Medicine Service on the Care for a Community-Dwelling Patient with Intractable Cancer Pain

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