Authors (including presenting author) :
Fung LC, Cheung SC, To CN, Lam PYW, Wong MC, Lee AS, Ngar D
Affiliation :
Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, HKSAR
Introduction :
Y-90 transarterial radioembolization (Y-90 TARE) is a procedure for management of HCC in which microspheres impregnated with radioactive Y-90 are injected into the hepatic arteries supplying the tumor. Those microspheres become lodged in blood vessels surrounding the tumor and resulting radiation damage to nearby tissue. Y90-TARE has been incorporated into the treatment recommendations of the American Association for the study of Liver Diseases guideline. Patient received Y-90 TARE will have radiation hazard and required special care and isolation in hospital. Besides, it was a new clinical services for NTWC, frontline staff were not unfamiliar with the caring Y-90 TARE. Patient also required various transportation between ward, interventional radiography and nuclear medicine department. Liaison between hospital foreman, portering staff, physicists, nursing and medical staff was definitely required. To tackle the challenge, a team approach was adopted.
Objectives :
1. To enhance understanding of caring of patients received Y-90 TARE among frontline staffs.
2. To ensure the frontline staff familiarize guidelines and workflow of Y-90 TARE.
Methodology :
1. A workforce group including supervisors, nursing staff, medical officer and physicists was formed to deliberate details in caring of patients receiving Y90-TARE.
2. A workflow was established which illustrated patient care for Y-90 TARE patients from admission to discharge day.
3. Hospital foreman was liaised for transportation services. Transportation for Y-90 TARE patients would regard as urgent and would completed as soon as possible.
4. A drill was held in December, 2020 to identify potential issues in actual practice of transferal of patient between ward, interventional radiography and nuclear medicine department. Issue identified was discussed and tackled in debriefing of drill.
5. An in-house sharing of Y-90 TARE to nursing and supporting staff was conducted by senior physicist in October 2020. All ward staff shown understanding on the caring of Y-90 TARE patient after the sharing.
Result & Outcome :
1. One patient was admitted for Y-90 TARE in December, 2020 and discharged uneventfully. Debriefing performed to frontline staff for alerting important points.
2. Another Y-90 TARE patient was admitted on January, 2021 uneventfully.
3. Ward staff shown positive feedback in caring for Y-90 TARE patients.
