Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery

a randomised controlled trial

M. Wells, A. Harrow, P. Donnan, P. Davey, S. Devereux, G. Little, E. McKenna, R. Wood, R. Chen, A. Thompson

    Research output: Contribution to journalArticle

    29 Citations (Scopus)

    Abstract

    Patients with breast cancer who require axillary clearance traditionally remain in hospital until their wound drains are removed. Early discharge has been shown to improve clinical outcomes, but there has been little assessment of the psychosocial and financial impact of early discharge on patients, carers and the health service. This study aimed to evaluate the effectiveness of a nurse-led model of early discharge from hospital. Main outcome measures were quality of life and carer burden. Secondary outcomes included patient satisfaction, arm morbidity, impact on community nurses, health service costs, surgical cancellations and in-patient nursing dependency. A total of 108 patients undergoing axillary clearance with mastectomy or wide local excision for breast cancer were randomised to nurse-led early discharge or conventional stay. Nurse-led early discharge had no adverse effects on quality of life or patient satisfaction, had little effect on carer burden, improved communication between primary and secondary care, reduced cancellations and was safely implemented in a mixed rural/urban setting. In total, 40% of eligible patients agreed to take part. Nonparticipants were significantly older, more likely to live alone and had lower emotional well being before surgery. This study provides further evidence of the benefits of early discharge from hospital following axillary clearance for breast cancer. However, if given the choice, most patients prefer to stay in hospital until their wound drains are removed.
    Original languageEnglish
    Pages (from-to)651-658
    Number of pages8
    JournalBritish Journal of Cancer
    Volume91
    Issue number4
    DOIs
    Publication statusPublished - 2004

    Fingerprint

    Caregivers
    Health Services
    Randomized Controlled Trials
    Nurses
    Breast Neoplasms
    Patient Satisfaction
    Quality of Life
    Community Health Services
    Secondary Care
    Patient Discharge
    Mastectomy
    Wounds and Injuries
    Health Care Costs
    Length of Stay
    Primary Health Care
    Nursing
    Communication
    Outcome Assessment (Health Care)
    Morbidity

    Keywords

    • Breast cancer
    • Axillary clearance
    • Nurse led
    • Early discharge

    Cite this

    Wells, M. ; Harrow, A. ; Donnan, P. ; Davey, P. ; Devereux, S. ; Little, G. ; McKenna, E. ; Wood, R. ; Chen, R. ; Thompson, A. / Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery : a randomised controlled trial. In: British Journal of Cancer. 2004 ; Vol. 91, No. 4. pp. 651-658.
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    abstract = "Patients with breast cancer who require axillary clearance traditionally remain in hospital until their wound drains are removed. Early discharge has been shown to improve clinical outcomes, but there has been little assessment of the psychosocial and financial impact of early discharge on patients, carers and the health service. This study aimed to evaluate the effectiveness of a nurse-led model of early discharge from hospital. Main outcome measures were quality of life and carer burden. Secondary outcomes included patient satisfaction, arm morbidity, impact on community nurses, health service costs, surgical cancellations and in-patient nursing dependency. A total of 108 patients undergoing axillary clearance with mastectomy or wide local excision for breast cancer were randomised to nurse-led early discharge or conventional stay. Nurse-led early discharge had no adverse effects on quality of life or patient satisfaction, had little effect on carer burden, improved communication between primary and secondary care, reduced cancellations and was safely implemented in a mixed rural/urban setting. In total, 40{\%} of eligible patients agreed to take part. Nonparticipants were significantly older, more likely to live alone and had lower emotional well being before surgery. This study provides further evidence of the benefits of early discharge from hospital following axillary clearance for breast cancer. However, if given the choice, most patients prefer to stay in hospital until their wound drains are removed.",
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    Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery : a randomised controlled trial. / Wells, M.; Harrow, A.; Donnan, P.; Davey, P.; Devereux, S.; Little, G.; McKenna, E.; Wood, R.; Chen, R.; Thompson, A.

    In: British Journal of Cancer, Vol. 91, No. 4, 2004, p. 651-658.

    Research output: Contribution to journalArticle

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    AU - Chen, R.

    AU - Thompson, A.

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