title: Collaborative lymphoedema management: developing a clinical protocol.
abstract: Lymphoedema is a very distressing chronic condition prevalent in some metastatic cancers. Conservative treatment of lymphoedema in palliative care involves complete/complex decongestive therapy (CDT) using manual lymphatic drainage (MLD), compression therapy (bandaging and/or garments), skincare, and remedial exercises, adapted to the needs of the patient. The aim of this service development project was to identify current practice in a hospice palliative care service, develop new assessment tools, and implement a collaborative clinical protocol to improve access to lymphoedema management for patients in the hospice. Two audits provided new evidence about patient profiles, patient assessment, and treatment outcomes for cancer- and non-cancer-related lymphoedema. This project had a quality-improvement effect on service delivery and developed an effective partnership approach to lymphoedema management between local district nursing services and the specialist lymphoedema physiotherapist.
authors.affiliation: Nurse Maude Hospice Palliative Care Service, Christchurch, New Zeland. maryt@nursemaude.org.nz
authors.forename: Mary
authors.initials: M
authors.lastname: Thomson
authors.forename: Jackie
authors.initials: J
authors.lastname: Walker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications