P201 Evaluating and supporting community care of patients with indwelling pleural catheters in inner London

Abstract

<h3>Background</h3> Indwelling pleural catheters (IPCs) are a recommended first line treatment option in the management of malignant pleural effusions. The MY-IPC study highlighted the variability of psychosocial impacts experienced by patients with IPCs, with quality of community care being a key modulatory factor. <h3>Aims</h3> 1. Investigate the training, confidence, and experience of district nurses (DNs) in managing IPCs and identify commonly encountered issues <b>2.</b> Develop and implement strategies to support DNs based on the above <h3>Methods</h3> A questionnaire evaluating aim 1 was designed and distributed to DNs working in two central London boroughs between January and February 2024 (figure 1). <h3>Results</h3> 19 responses were received. 16/19 (84%) respondents felt fairly or very confident looking after IPC patients, with 8/19(42%) having looked after an IPC within the last 3 months.17/19 (89%) respondents had received some form of training on IPC management, ranging from formal training to informal ‘on the job’ training. Of those trained, 5/17 (29%) were not satisfied with the training received. Key issues reported by DNs when looking after IPC patients included medical problems (drainage haemodynamic parameters, blockages, infection, pain), managing patient expectations and absence of patient care plans. 4/17 (24%) did not know how to order more bottles. 10/17 (59%) did not have contact details for the secondary care teams to contact with queries. DN perceived challenges that patients faced with community IPC care included medical and practical drainage issues; none recognised wait time for community drainage as a challenge. When asked how they could be better supported in looking after IPC patients, 16/19 (84%) felt more frequent training on IPC management would be helpful. <h3>Outcome</h3> Given the heterogenous training, confidence, and experience of IPC management amongst DNs, the following strategies were instigated to support them. 1) Biannual secondary care led training sessions on IPC management and troubleshooting focusing on DN highlighted issues. The first session received highly positive feedback with 8/9 (89%) of post-attendance respondents reporting an increase in their confidence managing IPCs. 2) Crib sheet on troubleshooting IPC related issues with consolidated contact information for local secondary care teams and industry liaisons to facilitate communication