BPKMCH | ANNUAL REPORT - 2018
DEPARTMENT OF NURSING
Introduction:
B.P. Koirala Memorial Cancer Hospital’s Department of Nursing provides the quality cancer care to pat ents of
all ages across the cont nuum of care — prevent on, risk determinat on, early detect on, treatment, symptom
management, survivorship, and palliat ve care in a wide variety of clinical set ngs. We provide pat ent- and
family-centered care. We provide nursing care in collaborat on with physicians and other members of the
healthcare team. The scope of our nursing pract ce is dynamic. We believe and focus that our professional
pract ce model is Relat onship-Based Care and our care delivery model is Primary Nursing.
Department of nursing is involving in various services in a wide variety of clinical set ngs as outpat ent care
(OPD), in-pat ent care, cancer screening, diagnost c and intervent onal procedure areas, oncology emergency
care unit, operat on theater, hospice and palliat ve care, in-service educat on program else.
Services:
Out-patients services:
In the cancer care centre, Nurses play pivotal role in different types of treatment. Nursing services in
different areas of outpat ent department has been running since the establishment of the hospital. Minor
operat ve procedures, biopsies, wound management, dressing, suturing are done at minor operat on theater.
Breast care clinic is responsible for counseling of newly diagnosed breast carcinoma pat ent, facilitat ng peers
counseling, educat ng the pat ent for prevent on and management of lymphedema afer get ng treatments,
teaching the pat ent for the preparat on of breast prosthesis locally, draining the seroma collect on afer
surgery, dealing the pat ent for their other concerns and psychosocial issues. Stoma care clinic caters the
needs of ostomate along with distribut on of ostomy appliances, Stoma site marking, dressing, complicat on
management, ostomate meet ng, self-care guidelines/ teaching, and counseling. Gilvac and Sutent clinic
distributes medicine and educates the client about side effect and management of the medicine. Counseling
for treatment compliance and regular follow up is another major service of the clinic. Palliat ve care clinic
provides the services of pain and other symptom management for terminally ill cancer pat ent. Inpat ent
consultat ons and community/ home visits are other major act vit es of it. Community services/ home visits
are the praiseworthy part of palliat ve clinic. Endoscopy unit is also covered by nursing services where ECG and
Pulmonary funct on test are done. At OPD- Breast clinic, Stoma clinic and Palliat ve clinic are independently
run by the nurses.
Daycare Centre: Daycare centre is one of the main areas of cancer treatment where twelve-hour service
(7am-7pm) is covered by nurses. Different act vit es like infusion of short term chemotherapy via different
routes, pre, and post hydrat on, and different therapeut c procedures, etc are carried out in daycare center.
Nurses are also responsible for counseling and health educat on of side-effects management of any cytotoxic
drugs. In average more 40 than pat ents get chemotherapy per day from daycare center in 2018AD.
CSSD: It is the backbone of the hospital. It provides sterile equipment and sets as per the need of different
units and departments.
Urgent Care Unit / Blood transfusion service :
The urgent care unit: is providing twenty-four hours nursing services to the cancer pat ents. Currently,
Twenty-two beds are available for observat on and oncology emergency management It is equipped for the
management of side-effects afer get ng cancer treatments such as surgical complicat ons, chemotherapy,
and radiotherapy-induced nausea, vomit ng and else. Here, Nurses are commited to provide holist c care to
cancer pat ents.
Blood Transfusion Services: Pat ents with low blood count are managed in blood transfusion unit.
Different types of blood components for e.g. whole blood, packed cell, platelets, and plasma rich protein are
transfused.
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BPKMCH | ANNUAL REPORT - 2018
Table 1 : Services of OPD ( Out Pat ent Department )
2018 AD
Sn
Type Of Services
Male
Female
Total
Expired
1
Minor OT
Biopsy
456
387
843
Bone Marrow Aspirat on
332
231
563
Dressing
3392
3976
7368
Others
51
61
112
Grand Total
4231
4655
8886
2
Endoscopy Unit
1
Broncoscopy
540
440
980
2
OGD
726
806
1532
3
Esophageal Dilatat on
11
3
14
4
OGD Guided N/G Inserton
3
3
5
NPL
721
590
1311
6
Cystoscopy
297
331
628
7
Sigmoidscopy
121
121
242
8
Colonoscopy
199
169
368
Grand Total
2615
2463
5078
3
ECG
2660
2960
5620
4
Stoma Clinic ( Number 0f Visit
Colostomy
474
356
830
Urostomy
237
70
307
5
Palliat ve Clinics
OPD Service
364
384
748
Home Visit
30
Indoor Consultat on service
35
26
61
Grand Total
839
6
Gilvac & Sutent Clinic
Gilvac
629
383
1012
Sutent
159
58
217
Nilot nib
21
11
32
Sprycel
2
2
Grand Total
809
454
1263
7
Breast care clinics
15
15
8
Day care services
5847
9150
14997
9
Urgent Care Unit
15339
17919
33258
107
10
BT Services
4372
Inpatients nursing services:
In-pat ents Nursing Services are covered in shif basis for twenty-four-hour. It is one of the major service
areas of nurses.
Medical Oncology Nursing Services
In medical oncology nursing service, nurses mainly deal with the pat ents receiving long term cytotoxic drugs.
Preparat on, administrat on and safe handling of cytotoxic drugs are the main responsibilit es of the nurses.
Counseling service is provided to all pat ents and their caregivers before administrat on of cytotoxic drugs.
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BPKMCH | ANNUAL REPORT - 2018
Educat ng the pat ents and their caregivers for side-effect management of every cytotoxic agent. Specialized
care is provided for neutropenic pat ents. Special teaching is given to the pat ents at the t me of discharge.
Radiation oncology nursing services:
Nurses working at radiat on oncology services are involved both In-pat ents and Out-pat ents set ng. Those
pat ent who are get ng radiat on therapy needs special preparat on and care before and afer therapy. Such
pat ents and their caregivers need special counseling about diet, hydrat on, skincare, and other side effects
management. Nurses play a crucial role in acute and delay side-effects management afer taking radiotherapy
treatment. Each pat ent and his/her caretaker are counseled about treatment procedures and their side-
effects management
Surgical oncology nursing services
In Surgical oncology set ng, nursing services are covered in various surgical unit of the hospital -such as
Breast, Gyane,Uro,ENT,GI,Ortho,Neuro and Thoracic else. Of course, oncological surgical procedures are
different than general surgery because of its radical nature, mult ple drains and so on. Not only the surgery
is challenging but also the specialized nursing care to those cancer pat ents are challenging task for nurses.
The prime responsibilit es of the nurses those who are involved in the surgical ward are provided special care
for pre and post-operat ve period. Nurses are not only involved in surgical procedures and dressing but also
involved in counseling and health educat on. Immediate afer surgery, pat ents are received in Post-operat ve
ward. Usually pat ents are kept in close observat on for first twenty-four hours and then shifed at respect ve
ward and unit. In the post-operat ve ward, Bio-monitors and Vent lators are available for special monitoring
and respiratory support.
Hospice and Palliative Care:
The main aim of the hospice and palliat ve care unit is improving the quality of life of terminally ill cancer
pat ents. It provides comprehensive services by a mult disciplinary team. Pain and other symptoms
management are major act vit es of hospice and palliat ve care services. Support ve care and bereavement
counseling are provided to family members for coping with illness and bereavement.
Table 2: Service of In-pat ent Department 2018
Sn
Department / Ward
1
Medical Oncology Ward I
Male
Female
Total
DOPR /LAMA
Expired
1
Medical Unit I
461
345
806
6
6
2
Medical Unit II
293
208
501
10
5
3
Paediatric
220
90
310
3
10
Grand Total
974
643
1617
19
21
2
Haemato Oncology
1
Adult
37
18
55
5
4
2
Paediatric
36
25
61
5
6
Grand Total
73
43
116
10
10
3
Medical Oncology Ward II
1
Medical Unit I
95
81
176
2
Medical Unit II
80
71
151
Grand Total
175
152
327
4
Radiat on Oncology / ENT
1
Radiat on Unit
491
534
1025
7
2
Medicine II
282
213
495
2
7
3
ENT
82
40
122
Grand Total
855
787
1642
2
14
5
Surgical Oncology
1
Uro
275
117
392
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BPKMCH | ANNUAL REPORT - 2018
2
Gynae
224
224
Grand Total
275
341
616
6
Surgical Oncology
1
ENT
214
115
329
1
2
2
Neuro
16
13
29
1
1
Grand Total
230
128
358
2
3
7
Surgical Oncology
1
GI
149
220
369
1
2
Ortho
74
54
128
3
Breast
6
118
124
4
RT
84
225
309
4
5
Others
51
28
79
Grand Total
364
645
1009
5
8
Surgical Oncology
1
Thoracic
218
213
431
9
4
2
Ortho
35
22
57
Grand Total
253
235
488
9
4
9
Post- Operat ve Ward
827
913
1740
6
29
10
Hospice ( In-Pat ent Service )
150
155
305
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Operation Theater Services:
Operat ng theater management is the challenging task to the team as Onco-surgeries are radical in nature
and mult organs are involved. Nurses working in the theater are successfully facing the challenge and fulfilling
the demands of operat ng team by playing the central role among the team members
Table 3 Total service Of Operat on Theater 2018
Sn
Services
Major OT
Intermediate
Minor
Total
Male
Female
1
Head & Neck Surgery
371
291
367
1029
695
334
2
Thoracic Surgery
381
26
125
532
248
284
3
Urology Surgery
294
25
81
400
280
120
4
Gynecology Surgery
176
133
29
338
338
5
Orthopedic Surgery
168
151
48
367
201
166
6
Gastro intest nal Surgery
274
15
43
332
128
204
7
Breast Surgery
181
13
42
236
6
230
8
Neuro Surgery
25
1
4
30
18
12
9
Emergency OT
52
9
6
67
41
26
Grand Total Operat on
1922
664
745
3331
1617
1714
Human Resource Development :
Many nurses are studying Master and bachelor of nursing in different universit es of the country
Nurses are facilitated for different training within and outside the country.
Two Nurses are visited at Hebei 4th hospital for one and half month on observat on training of Platelet
Pheresis Procedure.
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BPKMCH | ANNUAL REPORT - 2018
Academic Activities :
Nursing in-service educat on unit is commited to improve the quality care of the cancer pat ent by augment ng
the knowledge and skill through cont nue nursing educat on.
This includes: Orientation/ Induction Training.
Newly recruited staffs are trained and oriented before post ng to the respect ve wards. Orientat on
includes the rule/ regulat ons and policies of the hospital, different types of procedure/ related to
cancer care, different funct ons as per the specializat on of wards and special care needed to the
clients and their family.
Nursing Students from different university are post ng for oncology clinical exposure. Time durat on
varied from college to college.
Nurses are part cipated and presented their paper at Nat onal and Internat onal conferences.
Human Resources
Nursing department consists of various categories of nurse’s range from senior nursing supervisor to the staff
nurse level. There are altogether 240 nurses working in the department. It is the biggest department in the
view of human resources. At present:
Ms. Anita Devkota Chief, Department of Nursing
1 . Ms. Mina Sibakot , Nursing Supervisor (Former Nursing Chief)
2.
Mr. Rajendra Malli, Senior Sister
3.
Ms. Anupa Thapa, Senior Sister
4.
Ms. Sabitri Devi Bhurtel, Senior Sister
5.
Ms. Babita Subedi, Senior Sister
Sister / Unit manager of different Ward.
1.
Ms. Rita Chapagain : Medical Oncology Ward I
2.
Ms. Goma Devi Kandel : OPD
3.
Ms. Durga Khanal : Post OP
4.
Ms. Laxmi Neupane : Urgent care Unit / Blood transfusion services
5.
Ms. Janaki Dotel : Thoracic/ Ortho ward
6.
Ms. Mina Kumari Ranabhat : Surgical Oncology Ward III
7.
Ms. Kopila Khadka : Operat on Theater
8.
Ms. Sita Chapagain : Medical Oncology ward II
9.
Ms. Maya devi Mahato : ENT Ward
10. Ms. Himal Shova Katel : Hematology Ward
7.
Senior Staff Nurse = 37
8.
Staff Nurse = 187
Future Plans
Nursing department is planning for:
Three (3) months Basic Oncology Nursing Training once in a year.
One month Basic Stoma Care Training once in a year
One month Basic Palliat ve Care Training once in a year
Provision of Nat onal and Internat onal training on oncology nursing for different level of nursing
staffs.
Conclusion:
At BPKMCH, Nursing department believes that caring is the foundat on and crit cal component of nursing
pract ce. Caring is accomplished with wisdom, knowledge, compassion, and competence. Holist c nursing
care is the main aim of the department. The primary responsibility of the department is to provide quality
care in different pract ce set ng. The department is always focused on team approaches which include
mult disciplinary team in the hospital.
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