SURNAME : FORENAME:

Other name/s :

Date of Birth :

Proficiency assessment sheet for nurses wishina to work inOncology

1 = Perform infrequently - less than 3 months experience. Needmore experience. Assistance required.

2 = Limited experience 6 to 12 months within the last 2 years.Would require some assistance.

3. = Perform well. At least 1 year of current experience.Very comfortable performing with out supervision.

Please tick ( /) only on the Self-Assessment part of the Questionnaire (left handside of the page)

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I Knowledge of principles of Code of ProfessionalConduct,

Formulates decisions about care within the scope of

nursing practice utilising the principles in the Scope of

Nursing Practice Framework

Ensure confidentiality of information

Maintenance of patient records

... accurate account of treatment given

all enteries to patient records are signed

Implements Hospital I Departmental Manuals

Haemovigilance Manual

Royal Marsden Manual

Appendix to the Royal Marsden includingMedication Policies

Nursing Policies

Infection Control Policies

RISK MANAGEMENT(Time frame 3 weeks)

Waste Disposal

Clinical

Non Clinical

Infectious

Body Fluids

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ACCURATELY MEASURES VITALSIGNS

Temperature (tympanic)

Pulse Respirations (rate and quality)

Blood pressure

MONITORING

Accurately record and interpret fluid balancemeasurements

Urinalysis

Circulation, motor, sensory

Neurological monitoring (Glascow Coma Scale) I

EQUIPMENT

Use of:

Dinamap

Tympanic thermometer

Syringe pump !Infusion pump

Patient Hoist

Grasby Syringe Driver Pump

Glucometer

Glucometer ! Quality check

INTRAVENOUSCARE

Care of intravenousaccess site

Removal of peripheral cannula

Recognises complications of LV.therapy

BLOOD! BLOOD PRODUCTS ADMINISTRATION

Verify order to administer blood product.

Complete appropriate requisition form.

Administration of blood! blood products as perhospital policy.

Initiate appropriate action in the event of a transfusionreaction

MEDICATION ADMINISTRATION

Administer medications according to hospital policiesand procedures

Adhere to the controlled drugs policy

Verbalise knowledge of medications beingadministered

Utilise appropriate reference materials (Mimms, BNF,Intranet)

Record and sign all medications administered and USEthe necessary code for omissions on the medicationrecord

COMMUNICATION

Respect patients privacy, dignity and autonomy

Promptly advise CNM or Nurse in charge of needs orchanges on the ward/dept

Effectively communicate with other members of thehealth care team to give or seek information tooptimise patient care

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work to foster good customer relations by exhibitingcourtesy in both personal and phone interactions

!Interpret and respond effectively to verbal, non-verbaland written communication with colleagues.

Demonstrate strong listening and receptive skills

Spoken communication is clear, concise, accurate,sensitive and appropriate

Written communication is clear, concise and accurate

and appropriate

Patient reportlhandover at change of shift

Knowledge to prioritise patient care and work-load

Uses critical thinking and professional judgementwhen caring for patients

Works within a team and supports members towardsachieving common goals

Order medications from pharmacy as required

Aware of procedure for obtaining out of hoursmedications

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PATHOPHYSIOLOGY

Describe the nonnal cell cycle "

Nonnal White Cell count

I Nonnal Haemoglobin

Nonnal Neutrophil Count

Nonnal Platlets

NonnalRenal! Liver!Boneprofile I

The following Markers

I P.SA (Prostate)

, C,E,A ( Colon)

CA 125 (Ovarian)

Testicular markers

CA 19.9 (Breast)

,I c, A. 15,3 (Breast)PATIENT AND FAMILY EDUCATION

Outline the necessary steps of patient and familyeducation in relation to

(a) preparation

(b) planning

(c) presentation

(d)follow-up I

(e) documentation

Identify the infonnational needs of the patient and fam Iy

(a) the treatment

(b) how the treatment will work

(c) the sequence of administration

(d) recognising and controlling side effects

(e) reporting of side effects

Discuss use of helpline for oncology patients

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SYMPTOM MANAGEMENT

Identify important self care measures for patientsundergoing chemotherapy treatment

Describe the symptomatic management of

(a) alopecia

(b) stomatitis

(c) nausea and vomiting

(d) diarrhoea and constipation

.. (e) fatigue

(f)pain

Acute

I Chrol)ic

(g) febrile neutropenia IAnalgesia Ladder

CENTRALVENOUSACCESS DEVICES

Describe the different types of central venous accessdevices available

Outline the nursing care and management of

(a) PICCS

(b) Implantable ports

(c) Tunnelled catheters (Hickman lines)

Complic.ations associated with central venous accessdevices

ADMINISTRATION OF CHEMOTHERAPY

Explain how drug dosages for chemotherapy arecalculated

Demonstrate how body surface area is calculated

Discuss reconstitution of chemotherapy

Discuss routes of administration

I Discuss vein selection and venepuncture

Discuss pre-treatment considerations

Explain the procedure for administering chemotherap\drugs

Explain the rationale for sequencing of drugadministration

Discuss prevention of vesicant extravasation

Discuss Mater Private Hospital policy in relation toextravasation

Describe the most common side effects of

chemotherapy drugs and outline the nursingmanagement of these side effects

Describe abnormal test results

Protocols for treatment

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ISAFE HANDLINGOF CHEMOTHERAPEUTICDRUGS

Discuss the safe transportationof chemotherapydrugs ,

Describe protectiveequipmentto be wom duringhandling and administrationof chemotherapydrugs

Discuss the disposalof suppliesand unuseddrugs.

Describe the steps to be takenwhen dealingwith aspillage of chemotherapy'..

ONCOLOGICALCOMPLICATIONS IDisemminated Intravascular Coagulation

Define D.LC.

Describe clinical features of D.LC.

Discuss the treatment of D.LC

HYPERCALCAEMIA

Define hypercalcaemia

Describe clinical features of hypercalcaemia

Discuss the treatment of hypercalcaemia

SEPTIC SHOCK

Define septic shock

Describe clinical features of septic shock

Discuss the treatment of septic shock

SPINAL CORD COMPRESSION

Define spinal cord compression

Describe clinical features of spinal cord compression IDiscuss the treatment of spinal cord compression

RADIATION THERAPY

Define radiation therapy

Discuss principles of radiation therapy

Describe the various methods of administeringradiotherapy

Discuss nursing management of patients undergoingradiotherapy treatment

Discuss the policy on radiation protection forstaff and patients

Describe the care of patients receiving Brachytherapy

Care of patients with insertion of wires -CLINICAL TRIALS

Demonstrate knowledge of clinical trials

Discuss current clinical trials in oncology'

Identify resources e.g research nurses attached to the

_ __________m___ - - - ------------- - - -- - ---------------

CANCERS OF THE BRAIN

Identify two common brain tumours

Describe clinical features manifested by brain tumoun' I

Describe a diagnostic work up for brain tumours

Discuss treatment modalities

I

Explain why the response rate to chemotherapy is lov.

.. Outline nursing care of patients diagnosed with braintumours

I

BREAST CANCERS

Describe clinical features of breast cancers

Describe how breast cancer is diagnosed I(a) symptomatic

(b) screen detected

Describe the different histological types of breast

I

cancer

Describe treatmentmodalitiesfor breastcancer IDiscuss the nursing management of the breast cancepatient

Pre and post operative care

COlORECTAlCANCERS

Describe clinical features of colorectal cancers

Describe a diagnostic work-up for colorectal cancer

Discuss treatment modalities

Discuss the nursing management of a patientdiagnosed with cotorectal cancer

GASTRO INTESTINAL CANCER

Describe clinical features of

(a) Cancer of the oesophagus

(b) Cancer of the stomach

Discuss treatment modalities of gastro-intestinalcancers

Describe a diagnostic work up for G.I patient

Outline nursing management of G.I patients

CANCER OF THE LIVER

Describe the clinical features of liver cancer

Describe a diagnostic workup for liver cancer

Discuss treatment modalities for liver cancer

Outline nursing management of patients diagnosedwith liver cancer

CANCER OF THE PANCREAS

Describe the clinical features of pancreatic cancer

Describe a diagnostic work up for pancreatic cancer

Discuss treatment modalities

Outline nursing management of patients withdiagnosed with cancer of the pancreas

IV

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CANCER OF THE GALLBLADDER

Describe the clinical features of cancer of the

gallbladder

Describe a diagnostic work up for cancer of the"

gallbladder

Discuss treatment modalitiesfor the treatmentofcancer of the gallbladder

Outline the nursing managementof patientsdiagnosedwith cancerof the gallbladder

PROSTATECANCER

Describethe clinical features of prostatecancer IDiscuss treatment modalities

Outline nursing management of patients with cancer 0the prostate

TESTICULAR CANCER

Describe the clinical features of testicular cancer

Describe a diagnostic work up for testicular cancer

Discuss treatment modalities for testicular cancer

Outline nursing management of patients diagnosedwith testicular cancer

RENAL CELL CANCER

Describe the clinical features of renal cell cancer

I Describea diagnosticwork up for renalcell cancer

Discusstreatmentmodalitiesfor renalcell cancer iOutline nursing management of patients diagnosedwith renal cell cancer

BLADDER CANCER

Describe the clinical features of bladder cancer

Describe a diagnostic work up for bladder cancer

Discuss treatment modalities for bladder cancer

Outline nursing management of patients diagnosed

Iwith bladder cancer

GYNACOLOGICAL CANCERS

Describe the clinical features of gynaecological cance

(a) cervical

(b) endometrial

(c) ovarian

(d) vulvar

Describe a diagnostic work up for gynaecologicalcancers

Discuss treatment modalities for treatment of

gynaecological cancers

Outline nursing management of patients diagnosedwith gynaecological cancer

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HEADAND NECKCANCERS

Describe the 8 anatomic regions of head and neckcancer

Describe a diagnosticwork up for cancersof the headand neck

Discuss treatment modalitiesfor the treatmentof heacand neck cancers

Outline nursingmanagementof patientswith headand neck cancer

I LUNG CANCERS

Discuss the clinical features of lung cancer

Describea diagnosticwork up for lung cancer IDiscuss treatmentmodalitiesfor lung cancer

Outline the nursingmanagementof lung cancer

I SKIN CANCER

Describe the clinical features of

(a) non- melanoma

(b) malignantmelanoma

Describea diagnosticwork up for skin cancers

Discuss treatmentmodalitiesfor skin cancers

Outline nursing managementof skin cancers

ACUTE LEUKAEMIA

Identify two types of acute leukaemia IDescribe clinical features of acute leukaemia

Discuss treatment modalities for acute leukaemia

Outline nursing management of patients diagnosed

Iwith acute leukaemia

CHRONIC MYELOGENOUS LEUKAEMIA

Discuss the clinical features of CMl

Discuss treatment modalities for CMl

Outline nursing management of patients diagnosedwith CMl

CHRONIC LYMPHOCYTIC LEUKAEMIA

Discuss the clinical features of Cll

Discuss treatment modalities for Cll

Outline nursing management of Cll

Discuss the clinical features of myelodysplasticsyndrome

Describe a diagnostic work up for MDS

Discuss treatment modalities for MDS

Outline nursing management of MDS

MALIGNANT LYMPHOMAS

Discuss the clinical features of Hodgkins Disease

Describe a diagnostic work up for Hodgkins disease

Discuss treatment modalities for Hodgkins Disease

Outline nursing management of Hodgkins Disease

NON- HODGKINS LYMPHOMA

Describe the clinical features of NHL

Describe a diagnostic work-up for NHL

Discuss treatment modalities for NHL

Outline the nursing management of NHL

MULTIPLE MYELOMAS

Discuss the clinical features of multiple myeloma

Describe a diagnostic work up for multiple myeloma

Discuss the treatment modalities for multiple myeloma

Outline the nursing management of multiple myeloma

DIAGNOSIS AND STAGING

Explain how a diagnosis is made

Describe a diagnostic work-up

Identify three commonly used tumour markers

Describe grades of tumours

Describe the TMN staging system

PATHOPHYSIOLOGY

Describe the nonnal cell cycle

Describe the differences between benign andmalignant cells

Explain how chemotherapeutic agents interfere withthe cell cycle

CHEMOTHERAPY

Define chemotherapy

Describe five ways in which chemotherapy may beused

Explain the cell generation cycle

Discuss tumour growth

Discuss the blood brain barrier

Describe chemotherapeutic drug classifications andtheir potential action

12

Discuss tumour growth

Discuss the blood brain barrier

Describe chemotherapeutic drug classifications and

their potential action

Cell cycle phase specific

(a) antimetabilities

(b) vinca plant alkaloids

Cell cycle phase non-specific

(a) alkylating agents

(b) anti-tumour antibiotics

(c) hormones

(d) steroids

Give two examples of drugs in each group, and

discuss the potantial side effects and specialconsiderations prior to administration of each of thesedrugs

Describe a group of drugs that have the ability to crosthe blood brain barrier and give two examples of drugin this group and their method of administration

Discuss the cell kill hypothesis

Describe factors considered in drug selection

Explain combination chemotherapy

13