Posttraumatic stress disorder eventually arises as the brain increasingly attaches specific senses to a traumatic event. Patients and families are exposed to a series of stressful events that can transform their lives, including the initial cancer diagnosis, therapy, and acute and chronic physical symptoms such as hair loss, changes in body image, pain, and fatigue. Even after remission, survivors may develop cancer-related PTSD due to their fear of the disease coming back. Studies have demonstrated that cancer-related PTSD typically has a chronic course, but they have also shown that this population underutilizes mental health services to a significant degree. The nurse completing this project works at one of the largest cancer centers in the United States. The nurse notices the problem with her oncology patients and concentrates on raising awareness of posttraumatic stress disorder linked to cancer. The more quickly PTSD symptoms are recognized, the better the patient’s result.
Distress screening is intended to serve as the first stage in the more targeted evaluation of the source(s) of the patient’s distress because the word “distress” was purposefully chosen to encompass a broad idea (Smith et al., 2018). To be accredited, the American College of Surgeons’ Commission on Cancer began requiring screening for psychosocial distress in 2015 (Smith et al., 2018). The screening of distress is approved as the sixth vital sign and a standard of care that must be reached by any Canadian healthcare organization delivering cancer services that seeks accreditation (Smith et al., 2018). Similar screening criteria are in effect around the world (Smith et al., 2018). A proposed action step for implementing improved practice is a routine distress management that requires screening, tailored education, referral, and follow-up. Clinicians must emphasize to patients and family the significance of screening because those who recognize the value in distress management methods are more likely to take part. Screening patients for distress can provide clinicians with an idea about the patient’s mental health being. A patient who reportedly has distress may be screened for PTSD symptoms such as severe anxiety, trouble sleeping, flashbacks, and nightmares. Screening for emotional difficulties and disorders is now required in oncology due to the high prevalence (30-35%) of psychosocial and mental morbidity among cancer patients at any stage of the disease trajectory (Donovan et al., 2020). The process of screening starts when a patient enters the cancer care system and continues when it is clinically appropriate, occasionally while receiving active cancer treatment, or when it is clinically necessary trajectory (Donovan et al., 2020). In accordance with the application of distress management guidelines, the objective is to assist in proper referral to psychological oncology professionals for more specific assessment and care, as well as therapy and evaluation of the response trajectory (Donovan et al., 2020).
Other Proposed Action Steps
Giving nurses and nursing assistants instruction regarding PTSD symptoms is another necessary action step for improving the detection of PTSD in cancer patients. The most trustworthy people to determine whether a patient is displaying symptoms are nurses and aides because they spend more time with the patients. Forming a committee for PTSD screening can help the unit or hospital by giving continuous education to staff about PTSD and monitoring the patients’ referrals to behavioral medicine and outcome. Providing educational materials about PTSD and mental health upon patient’s discharge will be helpful for patients to recognize if they are having symptoms. Resources that can be utilized are behavioral health providers, social workers, chaplain, and case managers.
The compliance of these healthcare professionals is a potential issue that could jeopardize these suggested improvements. It can be difficult to convince many employees to accept new implementations. Another challenge that may occur is that nurses are too busy managing the patient’s care, such as addressing pain, and may not screen the patient for distress and/or PTSD symptoms. Nurses and staff may also not be interested in attending or doing their educational courses about PTSD. Forming a PTSD committee can also be challenging if no one wants to participate. Implementing the proposed actions can be costly, as time is needed to educate staff and the committee to meet and plan the implementation.
Taking care of cancer patients is already stressful for nurses and staff due to the complexity of the disease. Adding PTSD and mental health screening can be burdensome to some nurses and staff. However, with proper education and teaching, nurses and staff can realize the importance of mental health when dealing with cancer patients. The recovery and adaption of the cancer patient may be aided by mental health interventions explicitly targeted at cancer-related PTSD. All cancer patients should receive the best possible treatment for their psychological conditions, significantly to improve their quality of life.
Donovan, K. A., Grassi, L., Deshields, T. L., Corbett, C., & Riba, M. B. (2020). Advancing the science of distress screening and management in cancer care. Epidemiology and Psychiatric Sciences, 29. https://doi.org/10.1017/s2045796019000799
Smith, S. K., Loscalzo, M., Mayer, C., & Rosenstein, D. L. (2018). Best practices in oncology
distress management: Beyond the Screen. American Society of Clinical Oncology Educational
Book, (38), 813–821. https://doi.org/10.1200/edbk_201307
If you fall, you could sustain a severe injury. With these easy fall prevention strategies, from evaluating your prescriptions to hazard-proofing your house, you can avoid falls. As you get older, physical changes, health issues, and occasionally the medications used to address those issues increase your risk of falling. Falls rank first among the injuries that older persons sustain. Home health patients receive care either in their own homes or at facilities like group homes, independent living homes, assisted living places, etc. The agency’s nursing staff provides these individuals with necessary medical treatment at home, like wound care, IV therapies, diabetic management, medication management, etc. At least one fall occurs in 2% of patients (Sam, 2022). Every fourth fall results in an injury, with 10% of those injuries being severe (Sam, 2022). According to the information provided, falls are a high-risk adverse event for the home health organization.
Some universal fall precautions which apply to all patients, regardless of fall risk, and focus on creating a secure and comfortable environment for the patient include the following: introduce the patient to the surroundings, ask the patient to exhibit calling light use, keep the call light close at hand, keep the patient’s items within reach, encourage patients to utilize the medical alert buttons/devices, inpatient toilets, rooms, and hallways, install robust railings, when a patient is sleeping, position the hospital bed low, if the patient needs to get out of bed, raise the bed to a comfortable height, lock the brakes on the hospital bed, when seated, keep the wheelchair’s wheels locked (Yang, 2022).
Furthermore, you should visit your doctor and make a list of all of your prescription, over-the-counter, and dietary supplements or bring them to the appointment (Hogan, 2021). Your doctor can check your drugs for interactions and adverse effects that can make you dizzy, trip, and fall. Your doctor may think about weaning you off drugs that make you tired or impair your thinking, like sedatives, antihistamines, and some types of antidepressants, to help prevent falls (Loria, 2022).
To help you stay balanced, patients may use an assistive device like a walker or cane. Various other aids can be helpful too. For instance: stairways with handrails on both sides, steps with non-slip treads for bare wood, a toilet seat with arms or an elevated seat, grab bars for the bathtub or shower, a strong plastic seat for the tub or shower, as well as a hand-held shower nozzle for taking a shower while seated. If required, request a recommendation for an occupational therapist from your doctor (Harper, 2021).
A possible problem that imperils these suggested improvements is the patients’ compliance. Many patients can be hard to persuade to embrace new implementations in their living environment and lifestyle. The patient may be unable to implement all the suggested cautions because home health nurses don’t usually visit these patients more frequently but less frequently, like once a week. Nurses are also too busy managing the patient’s other care. The suggested solutions can be implemented free of cost, except for hiring a physical or occupational therapist, which can be expensive.
Sam, P. R., & Lee, P. (2022). Perception: A Critical Analysis of the Hospitalized Patients on Falls. International Journal of Nursing Education, 14(3), 127–130. https://doi.org/10.37506/ijone.v14i3.18365Links to an external site.Links to an external site.
Yang, Y., Ye, Q., Yao, M., Yang, Y., & Lin, T. (2022). Development of the Home-Based Fall Prevention Knowledge (HFPK) questionnaire to assess home-based fall prevention knowledge levels among older adults in China. BMC Public Health, 22(1), 1–17. https://doi.org/10.1186/s12889-022-14546-2Links to an external site.
Hogan Quigley, B. (2021). Fall Prevention and Injury Reduction Utilizing Virtual Sitters in Hospitalized Patients: A Literature Review. Computers, Informatics, Nursing, pp. 929–934.
Harper, A. (2021). Falls in older adults: causes, assessment, and management. In Medicine.
Loria, K. (2022). A Closer Look at Falls and Falls Prevention. APTA Magazine, 14(8), 12–24.