TY - JOUR
T1 - Patient, carer and health service outcomes of nurse-led early discharge after breast cancer surgery
T2 - a randomised controlled trial
AU - Wells, M.
AU - Harrow, A.
AU - Donnan, P.
AU - Davey, P.
AU - Devereux, S.
AU - Little, G.
AU - McKenna, E.
AU - Wood, R.
AU - Chen, R.
AU - Thompson, A.
N1 - dc.publisher: Nature Publishing Group
This paper was selected for inclusion in a collection of papers demonstrating the contribution of the UK Federation of Primary Care Research Organisations (entitled Impact and Improvement 2005). It has had significant impact on practice locally. Wide dissemination at conferences regarding nurse-led care and breast services. Research Group 4 - Quality of Life and Quality of Care in Acute and Chronic Illness.
dc.description.sponsorship: Chief Scientist Office Health Services Research programme
K/OPR/2/2/D383
PY - 2004
Y1 - 2004
N2 - 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.
AB - 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.
KW - Breast cancer
KW - Axillary clearance
KW - Nurse led
KW - Early discharge
U2 - 10.1038/sj.bjc.6601998
DO - 10.1038/sj.bjc.6601998
M3 - Article
C2 - 15238983
SN - 0007-0920
VL - 91
SP - 651
EP - 658
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 4
ER -
