Advertisement

Multidisciplinary Care of Critically Ill Cancer Patients

  • Ninotchka BrydgesEmail author
  • Brandi McCall
  • Tiffany Mundie
Living reference work entry

Abstract

Critically ill cancer patients have complex physical and emotional needs that are best met by utilizing a multidisciplinary care approach. Physicians, advanced practice providers, nurses, clinical pharmacists, dieticians, physical therapists, occupational therapists, patient advocates, social workers, and chaplains are essential members of the multidisciplinary team working together to achieve a patient-centered approach when caring cancer patients in the intensive care unit (ICU). This chapter focuses on six different areas of the multidisciplinary team and discusses how each group is utilized to support the critically ill cancer patient. Oncologic considerations and challenges in regard to nursing, nutrition, physical and occupational therapy, patient support, advocacy and social work, and chaplaincy are thoroughly reviewed in relation to the critically ill oncologic patient.

Keywords

Intensive care unit Critical care Oncology nurse Compassion fatigue Enteral nutrition Parenteral nutrition Malnutrition Nutrition screening Nutrition assessment Physical therapy Occupational therapy Mobility Acquired weakness Delirium Early mobility Patient support Chaplain Chaplaincy Spiritual care Communication Advocacy Patient advocate Social worker 

References

  1. 1.
    Aksoy Y, Kaydu A, Sahin OF, Kacar CK. Analysis of cancer patients admitted to intensive care unit. North Clin Istanb. 2016;3(3):217–21.PubMedGoogle Scholar
  2. 2.
    Allen SR, Pascual J, Martin N, Reilly P, Luckianow G, Datner E, …, Kaplan LJ. A novel method of optimizing patient- and family-centered care in the ICU. J Trauma Acute Care Surg. 2017;82(3):582–86.CrossRefGoogle Scholar
  3. 3.
    Álvarez EA, Garrido MA, Tobar EA, Prieto SA, Vergara SO, Briceño CD, González FJ. Occupational therapy for delirium management in elderly patients without mechanical ventilation in an intensive care unit: a pilot randomized clinical trial. J Crit Care. 2017;37:85–90.CrossRefGoogle Scholar
  4. 4.
    American Occupational Therapy Association, Inc. Occupational therapy in acute care. 2017. https://www.aota.org/About-Occupational-Therapy/Professionals/RDP/AcuteCare.aspx. Accessed 20 Apr 2018.
  5. 5.
    American Physical Therapy Association. Role of a physical therapist. 2016. http://www.apta.org/PTCareers/RoleofaPT/. Accessed 20 Apr 2018.
  6. 6.
    American Society for Parenteral and Enteral Nutrition (ASPEN). Board of directors and clinical practice committee: definition of terms, style and conventions used in ASPEN board of directors-approved documents. 2012. http://www.nutritioncare.org/uploadedFiles/Home/Guidelines_and_Clinical_Practice/DefinitionsStyleConventions.pdf. Accessed 17 Apr 2018.
  7. 7.
    Anthony PS. Nutrition screening tools for hospitalized patients. Nutr Clin Pract. 2008;23(4):373–82.CrossRefGoogle Scholar
  8. 8.
    Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11–48.CrossRefGoogle Scholar
  9. 9.
    Argiles JM. Cancer-associated malnutrition. Eur J Oncol Nurs. 2005;9:S39–50.CrossRefGoogle Scholar
  10. 10.
    Association of Oncology Social Work (AOSW). Oncology social work standards of practice. 2012. http://www.aosw.org/professional-development/standards-of-practice/. Accessed 18 Apr 2018.
  11. 11.
    Astrow AB, Wexler A, Texeira K, Kai He M, Sulmasy DP. Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction of care? J Clin Oncol. 2007;25(36):5753–7.CrossRefGoogle Scholar
  12. 12.
    Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG. Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol. 2007;25(5):555–60.CrossRefGoogle Scholar
  13. 13.
    Berning JN, Poor AD, Buckley SM, Patel KR, Lederer DJ, Goldstein NE, Brodie D, Baldwin MR. A novel picture guide to improve spiritual care and reduce anxiety in mechanically ventilated adults in the intensive care unit. Ann Am Thorac Soc. 2016;13(8):1333–42.CrossRefGoogle Scholar
  14. 14.
    Board of Chaplaincy Certification, Inc. Certification frequently asked questions. 2018. http://bcci.professionalchaplains.org/content.asp?pl=25&contentid=26. Accessed 26 Mar 2018.
  15. 15.
    Choi PJ, Curlin FA, Cox CE. The patient is dying, please call the chaplain: the activities of chaplains in one clinical center’s intensive care units. J Pain Symptom Manag. 2015;50(4):501–6.CrossRefGoogle Scholar
  16. 16.
    Cunningham CJL, Panda M, Lambert J, Daniel G, DeMars K. Perceptions of chaplains’ value and impact within hospital care teams. J Relig Health. 2017;56(4): 1231–47.CrossRefGoogle Scholar
  17. 17.
    Deshields T, Zebrack B, Kennedy V. The state of psychosocial services in cancer care in the United States. Psycho-Oncology. 2013;22(3):699–703.CrossRefGoogle Scholar
  18. 18.
    Dowling J, Wang B. Impact on family satisfaction: the critical care family assistance program. Chest. 2005;128(3):76S–80S.CrossRefGoogle Scholar
  19. 19.
    Dy SM. Enteral and parenteral nutrition in terminally ill cancer patients: a review of literature. Am J Hosp Palliat Care. 2006;23(5):369–77.CrossRefGoogle Scholar
  20. 20.
    Epstein-Peterson ZD, Sullivan AJ, Enzinger AC, Trevino KM, Zollfrank AA, Balboni MJ, VanderWeele TJ, Balboni TA. Examining forms of spiritual care provided in the advanced cancer setting. Am J Hosp Palliat Care. 2015;32(7):750–7.CrossRefGoogle Scholar
  21. 21.
    Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489–95.CrossRefGoogle Scholar
  22. 22.
    Flannely KJ, Emanuel LL, Handzo GF, Galek K, Silton NR, Carlson M. A national study of chaplaincy services and end-of-life outcomes. BMC Palliat Care. 2012;11:10.CrossRefGoogle Scholar
  23. 23.
    Harris Interactive. What America thinks: MetLife Foundation Alzheimer’s survey. 2011. https://www.metlife.com/assets/cao/foundation/alzheimers-2011.pdf. Accessed 23 Mar 2018.
  24. 24.
    Hartman-Shea K, Hahn AP, Kraus JF, Cordts G, Sevransky J. The role of the social worker in the adult critical care unit: a systematic review of the literature. Soc Work Health Care. 2011;50(2):143–57.CrossRefGoogle Scholar
  25. 25.
    HealthCare Chaplaincy Network. Clinical pastoral education. 2018. https://healthcarechaplaincy.org/clinical-pastoral-education.html. Accessed 26 Mar 2018.
  26. 26.
    Healthcare Chaplains Ministry Association. History of healthcare chaplaincy and HCMA. 2018. http://www.hcmachaplains.org/history-of-healthcare-chaplaincy-and-hcma/. Accessed 26 Mar 2018.
  27. 27.
    Heron M. Death: leading causes for 2015. Natl Vital Stat Rep. 2017;66(5):1–75.PubMedGoogle Scholar
  28. 28.
    Ho JQ, Nguyen CD, Lopes R, Ezeji-Okoye SC, Kuschner WG. Spiritual care in the intensive care unit: a narrative review. J Intensive Care Med. 2017;33:279–87.CrossRefGoogle Scholar
  29. 29.
    Hodgson CL, Stiller K, Needham DM, Tipping CJ, Harrold M, Baldwin CE, …, Green M. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults. Crit Care. 2014;18(6):658.Google Scholar
  30. 30.
    Hui P, Cook DJ, Lim W, Fraser GA, Arnold DM. The frequency and clinical significance of thrombocytopenia complicating critical illness: a systematic review. Chest. 2011;139(2):271–8.CrossRefGoogle Scholar
  31. 31.
    Jacobs MR. What are we doing here? Chaplains in contemporary health care. Hastings Cent Rep. 2008;38(6):15–8.CrossRefGoogle Scholar
  32. 32.
    Kim MM, Barnato AE, Angus DC, Fleisher LF, Kahn JM. The effect of multidisciplinary care teams on intensive care unit mortality. Arch Intern Med. 2010;170(4):369–76.CrossRefGoogle Scholar
  33. 33.
    Kissane DW, McKenzie M, Block S, Moskowitz C, McKenzie D, O’Neill I. Family focused grief therapy: a randomized controlled trial in palliative care and bereavement. Am J Psychiatr. 2006;163(7):1208–18.CrossRefGoogle Scholar
  34. 34.
    Lach K, Peterson SJ. Nutrition support for critically ill patients with cancer. Nutr Clin Pract. 2017;32(5): 578–86.CrossRefGoogle Scholar
  35. 35.
    LaPierre LL. JCAHO safeguards spiritual care. Holist Nurs Pract. 2003;17(4):219.CrossRefGoogle Scholar
  36. 36.
    Marin DB, Sharma V, Sosunov E, Egorova N, Goldstein R, Handzo GF. Relationship between chaplain visits and patient satisfaction. J Health Care Chaplain. 2015;21(1):14–24.CrossRefGoogle Scholar
  37. 37.
    Massey K, Barnes MJD, Villines D, Goldstein JD, Pierson ALH, Scherer C, Laan BV, Summerfelt WT. What do I do? Developing a taxonomy of chaplaincy activities and interventions of spiritual care in intensive care unit palliative care. BMC Palliat Care. 2015;14:10.CrossRefGoogle Scholar
  38. 38.
    McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, …, Compher C. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM), and American Society for Parenteral and Enteral Nutrition (ASPEN). J Parenter Enteral Nutr. 2016;40:159–211.CrossRefGoogle Scholar
  39. 39.
    McCormick AJ, Engelberg R, Curtis JR. Social workers in palliative care: assessing activities and barriers in the intensive care unit. J Palliat Med. 2007;10(4):929–37.CrossRefGoogle Scholar
  40. 40.
    Mueller C, Compher C, Ellen DM, American Society for Parenteral and Enteral Nutrition (ASPEN) Board of Directors. Nutrition screening, assessment, and intervention in adults. J Parenter Enter Nutr. 2011;35(1): 16–24.CrossRefGoogle Scholar
  41. 41.
    National Association of Social Workers (NASW). Code of ethics. 2018. https://www.socialworkers.org/about/ethics/code-of-ethics. Accessed 1 May 2018.
  42. 42.
    Nordon-Craft A, Moss M, Quan D, Schenkman M. Intensive care unit-acquired weakness: implications for physical therapist management. Phys Ther. 2012;92(12):1494–506.CrossRefGoogle Scholar
  43. 43.
    Oncology Nursing Certification Cooperation (ONCC). Certifications. 2018. https://www.oncc.org/certifications. Accessed 19 Apr 2018.
  44. 44.
    Patel RP, Canada TW, Nates JL. Bleeding associated with feeding tube placement in critically ill oncology patients with thrombocytopenia. Nutr Clin Pract. 2016;31(1):111–5.CrossRefGoogle Scholar
  45. 45.
    Patient Advocate Certification Board (PACB). Frequently asked questions. 2018. https://pacboard.org/questions/. Accessed 12 Sept 2018.
  46. 46.
    Pène, F., Percheron, S., Lemiale, V., Viallon, V., Claessens, Y. E., Marqué, S., ... & Mira, J. P. (2008). Temporal changes in management and outcome of septic shock in patients with malignancies in the intensive care unit. Critical care medicine, 36(3), 690–696CrossRefGoogle Scholar
  47. 47.
    Puxty K, McLoone P, Quasim T, Sloan B, Kinsella J, Morrison DS. Risk of critical illness among patients with solid cancers: a population-based observational study. JAMA Oncol. 2015;1(8):1078–85.CrossRefGoogle Scholar
  48. 48.
    Schellongowski P, Staudinger T, Kundi M, Laczika K, Locker GJ, Bojic A, Robak O, Fuhrmann V, Valent P, Sperr WR. Prognostic factors for intensive care unit admission, intensive care outcome, and post-intensive care survival in patients with de novo acute myeloid leukemia: a single center experience. Haematologica. 2011;96(2):231–7.CrossRefGoogle Scholar
  49. 49.
    Schellongowski P, Sperr WR, Wohlfarth P, Knoebl P, Rabitsch W, Watzke HH, Staudinger T, Working Group for Hemato-Oncologic Intensive Care Medicine of the Austrian Society of Clinical and General Intensive Care Medicine and Emergency Medicine (OEGIAIN). Critically ill patients with cancer: chances and limitations of intensive care medicine – a narrative review. ESMO Open. 2016;1(5):e000018. http://esmoopen.bmj.com/content/esmoopen/1/5/e000018.full.pdf. Accessed 18 Apr 2018CrossRefGoogle Scholar
  50. 50.
    Schober AE, Thornton KC. Early mobilization in the intensive care unit. Curr Anesthesiol Rep. 2013;3(2):73–8.CrossRefGoogle Scholar
  51. 51.
    Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, …, Schmidt GA. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomized controlled trial. Lancet. 2009;373(9678):1874–82.CrossRefGoogle Scholar
  52. 52.
    Seron-Arbeloa C, Zamora-Elson M, Labarta-Monzon L, Mallor-Bonet T. Enteral nutrition in critical care. J Clin Med Res. 2013;5(1):1–11.CrossRefGoogle Scholar
  53. 53.
    Shimabukuro-Vornhagen A, Böll B, Kochanek M, Azoulay É, von Bergwelt-Baildon MS. Critical care of patients with cancer. CA Cancer J Clin. 2016;66:496–517.  https://doi.org/10.3322/caac.21351.CrossRefGoogle Scholar
  54. 54.
    “Spirituality” Merriam-Webster. https://www.merriam-webster.com/dictionary/spirituality. 2017. Accessed 25 Mar 2018.
  55. 55.
  56. 56.
    Toh SG, Ang E, Devi MK. Systematic review on the relationship between the nursing shortage and job satisfaction, stress and burnout levels among nurses in oncology/haematology settings. Int J Evid Based Healthc. 2012;10(2):126–41.CrossRefGoogle Scholar
  57. 57.
    Tzelepis F, Sanson-Fisher RW, Zucca AC, Fradgley EA. Measuring the quality of patient-centered care: why patient-reported measures are critical to reliable assessment. Patient Prefer Adherence. 2015;9:831.CrossRefGoogle Scholar
  58. 58.
    VandeCreek L. How satisfied are patients with the ministry of chaplains? J Pastoral Care Counsel. 2004;58(4):335–42.CrossRefGoogle Scholar
  59. 59.
    VandeCreek L, Burton L. Professional chaplaincy: its role and importance in healthcare. J Pastoral Care. 2001;55(1):81–97.CrossRefGoogle Scholar
  60. 60.
    Virizuela JA, Camblor-Alvarez M, Luengo-Perez LM, Grande E, Alvarez-Hernandez J, Sendros-Madrono MJ, Jimenez-Fonseca P, Cervera-Peris M, Ocon-Breton MJ. Nutritional support and parenteral nutrition in cancer patients: an expert consensus report. Clin Transl Oncol. 2017;20(5):619–29.CrossRefGoogle Scholar
  61. 61.
    Wahab R, Yip NH, Chandra S, Nguyen M, Pavlovich KH, Benson T, …, Perez-Mir E. The implementation of an early rehabilitation program is associated with reduced length of stay: a multi-ICU study. J Intensive Care Soc. 2016;17(1):2–11.CrossRefGoogle Scholar
  62. 62.
    Wall RJ, Engelberg RA, Gries CJ, Glavan B, Curtis JR. Spiritual care of families in the intensive care unit. Crit Care Med. 2007;35(4):1084–90.CrossRefGoogle Scholar
  63. 63.
    White JV, Guenter P, Jensen G, Malone A, Schofield M, Academy Malnutrition Work Group, ASPEN Malnutrition Task Force, ASPEN Board of Directors. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Parenter Enter Nutr. 2012;36(3):275–83.CrossRefGoogle Scholar
  64. 64.
    Zebrack B, Kayser K, Oktay J, Sundstrom L, Sachs AM. The Association of Oncology Social Work’s project to assure quality cancer care (APAQCC). J Psychosoc Oncol. 2018;36(1):19–30.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ninotchka Brydges
    • 1
    Email author
  • Brandi McCall
    • 1
  • Tiffany Mundie
    • 1
  1. 1.Department of Critical Care and Respiratory CareThe University of Texas MD Anderson Cancer CenterHoustonUSA

Personalised recommendations