Data collection for study: Open Publication date: Autumn 2018
The aims of this study are to study the process of care of children, Teens and Young Adults under the age of 25 years who died/ or had an unplanned admission to critical care within 30 days of receiving systemic anti-cancer therapy in order to:
Look at the decision making and consent process around the prescription of SACT in this group of patients.
Explore remediable factors in the quality of care provided to patients during the final line of therapy.
Look at preventable causes of treatment-related mortality in young people’s cancers.
Look at the configuration of the service and organizational structures in place for the safe delivery of SACT to children, teenagers and young adults.
The Prescription of the final course of SACT
The right protocol
The service overseeing the treatment decision/ prescription of SACT
The intent- palliation Vs cure
Performance status of the patient at time of prescription of the first cycle of SACT
Consideration of Toxicity/ side effects/ quality of life
The consent process
Communication of patient information between different services and communication of information to the patient
Was the patient on a clinical trial?
Delivery of last cycle of SACT
Process of prescription of last cycle of SACT
Performance/disease status at time of administration of SACT
Process of administration of SACT
Preventable death/ICU admission
Recognition of the sick patient throughout the pathway
Sepsis pathway: Antimicrobial delivery and fluid resuscitation
Appropriateness of ICU admission/access to ICU/ process of ICU admission
Types of service: PTC/ TYA-designated hospital/ POSCU
Pre-alerts from primary care? via GP, 111, POSCU , ambulance service
Peer review -CQUINS
Clinical governance/ RCA
Shared care centres/ POSCUs
Levels of care
Variation in the pathway- nearest POSCU
Transition child to adult
Structure of care delivery
Information/ staff training /education
Nursing staff / ambulance staff
Programmes of education in the organisation for haematological emergency – febrile neutropaenia.
Palliative care provision
Number of WTE devoted to age appropriate haematology/ oncology
Ratios/on-call ratios - Nursing
Dedicated Paediatric trained resus team
Competencies of staff
record sharing of chemotherapy administration between POSCU and PTC
Information for patients/ families
Neutopaenic fever guideline- linked to PTC
Protocol to deal with acutely unwell paediatric/TYA oncology patient
Is every treatment change for a given patients discussed at an MDT?
Which staff members attend
Children, teenagers and young adults under the age of 25 years (age at time of death/unplanned critical care admission).
Who have been diagnosed with a solid tumour (including CNS) or haematological malignancy* (using NICE definition)
And who received systemic chemotherapy* (using SACT data)
And died or underwent an unplanned admission to critical care within 60 days of receiving chemotherapy
Planned admissions to ICU for procedures such as surgery and incidental death/ICU admission e.g. for trauma
Cases of patients aged <25 years who died or were admitted to critical care and who were coded with ICD10 code (any position) for cancer (C0-C97) during the study period will be identified to us on a case identification spreadsheet. For these patients we will collect some basic data including: NHS number, case note number, applicable ICD10 codes, outcome, ICU admission date, date of admission/ discharge/ death, date of prescription of last line (course) of SACT, responsible prescribing clinician, date of delivery of final course (last line) of SACT, responsible clinician at delivery; Specialty admitted to (final admission), Whether the patient was admitted to ICU, date of admission to ICU, name of intensivist, name of discharging clinician.
An ONS run of data will be carried out for the same timeframe to make sure there are not case missed for patients who died outside hospital.
This webpage is updated regularly, so please check back for more information shortly.
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Frequently Asked Questions
Our hospital does not prescribe chemotherapy, do we have to take part?
If your hospital does not prescribe SACT then please let us know that this is the case. You do not need to complete the Treatment Data spreadsheet, but if your hospital does have an ICU then you can still complete the ICU/ death data spreadsheet (please see Tab 3 Data Collation – ICU/ death).
Your hospital may also still be eligible to complete an organisational questionnaire.