Journal Article

P278 Unexpected activity of the pleural nurse specialist for IPC patients in a tertiary centre

Hinchcliffe, F, Sudhir, R, Johnstone, S, Li D, Baguneid, A, Hand, A, Mohammad, S, Panchal, R, Newnham, N

2025

Overview

IntroductionThe Pleural Nurse Specialist (PNS) plays a pivotal role in the management of patients with indwelling pleural catheters (IPCs), particularly within a cohort often characterised by complex comorbidities and palliative care needs. Beyond performing pleural procedures, the PNS is instrumental in ongoing fluid surveillance, symptom control, patient support and care coordination. As the primary point of contact for IPC patients, the PNS is well positioned to respond to patient concerns. This analysis aimed to quantify the volume and nature of unplanned patient-initiated contacts with the PNS following IPC insertion, and to evaluate the associated clinical outcomes and service implications.MethodA retrospective analysis was conducted, reviewing patient contacts following IPC insertion between January and December 2024. Data were collected on unplanned telephone contacts initiated by patients or carers, subsequent interventions, and the number of planned and unplanned face-to-face (F2F) reviews.ResultsNinety-nine patients were included (median age 71 years; 52.5% male), of whom 64.6% were receiving systemic anti-cancer treatment. A total of 138 unplanned telephone contacts were recorded. Forty patients (40.4%) contacted the PNS two or more times. The average time to first call was five weeks post-IPC insertion. The most common reasons for contact were symptom reporting (e.g., breathlessness, pain) and requests for information or reassurance.Subgroup analysis by performance status (PS) suggested a trend toward higher call rates among those with PS 0–1, although this did not reach statistical significance (see table 1). Planned F2F reviews occurred in 82 patients (82.1%), with 41 patients (41.4%) attending at least two reviews. Following 23 patient-initiated calls (16.7%), unplanned F2F reviews were arranged, potentially averting escalation to primary or emergency care. Notably, 59.4% of emergency admissions (13/22) occurred outside of PNS service hours.Abstract P278 Table 1Summary of phone calls by patient to PNS teamDiscussionThese findings underline the value of the PNS, reducing emergency health service utilisation and maintaining continuity in pleural disease management. The capacity of the PNS to triage concerns, arrange timely intervention, and support patients holistically suggests a model of care that is both patient-centred and resource-efficient. Further work is needed to evaluate the impact of non-IPC-related PNS contacts on broader service delivery.

• Publisher: BMJ Publishing Group LTD
• Subject: Emergency medical care / Nurse specialists / Patients