Background:
Adequate and effective symptom control is essential to ensure quality of life. We present a case study demonstrating multiple teams working together to provide complex, patient centred, sustainable care, in the location of her choice.
A 46yo woman from a remote town in WA, with metastatic breast cancer and significant pelvic bony involvement, was requiring multiple analgesics to manage her pain. This led to significant toxicity, resulting in delirium and drowsiness.
Method:
She was transferred to Perth and an intrathecal catheter was placed, with significant improvement in her symptoms and decrease in opioid toxicity. Addressing emotional distress and providing support from counselling also contributed significantly to her comfort. Counselling was also useful in supporting her family, enabling them to continue to be involved in her care.
Upskilling and education for staff was essential to the safe use of this specialist technique. Medical and nursing team members travelled to Perth to learn about the practical and clinical aspects of an intrathecal. The metropolitan team travelled to the region to deliver intensive education to ward and emergency staff across multiple disciplines and also to the ambulance team.
Outcomes:
The patient was successfully transferred back to her home, with an intrathecal insitu. This continues to provide good symptom control, with ongoing care being provided by the local team with support from the metropolitan team.
Lessons learnt:
- education and support of the regional team created a confident and skilled workforce
- the use of technology enables pain specialists, palliative care specialists and rural team members to work together in a supported and sustainable way
Conclusion:
This case study displays the success of collaboration of remote and metropolitan palliative care teams to achieve specialist sustainable patient-centred care in remote Western Australia.
Adequate and effective symptom control is essential to ensure quality of life. We present a case study demonstrating multiple teams working together to provide complex, patient centred, sustainable care, in the location of her choice.
A 46yo woman from a remote town in WA, with metastatic breast cancer and significant pelvic bony involvement, was requiring multiple analgesics to manage her pain. This led to significant toxicity, resulting in delirium and drowsiness.
Method:
She was transferred to Perth and an intrathecal catheter was placed, with significant improvement in her symptoms and decrease in opioid toxicity. Addressing emotional distress and providing support from counselling also contributed significantly to her comfort. Counselling was also useful in supporting her family, enabling them to continue to be involved in her care.
Upskilling and education for staff was essential to the safe use of this specialist technique. Medical and nursing team members travelled to Perth to learn about the practical and clinical aspects of an intrathecal. The metropolitan team travelled to the region to deliver intensive education to ward and emergency staff across multiple disciplines and also to the ambulance team.
Outcomes:
The patient was successfully transferred back to her home, with an intrathecal insitu. This continues to provide good symptom control, with ongoing care being provided by the local team with support from the metropolitan team.
Lessons learnt:
- education and support of the regional team created a confident and skilled workforce
- the use of technology enables pain specialists, palliative care specialists and rural team members to work together in a supported and sustainable way
Conclusion:
This case study displays the success of collaboration of remote and metropolitan palliative care teams to achieve specialist sustainable patient-centred care in remote Western Australia.
