We would like to thank you for completing this audit questionnaire which looks at how you manage nausea and vomiting in palliative care patients.

Transcription

1 We would like to thank you for completing this audit questionnaire which looks at how you manage nausea and vomiting in palliative care patients. The closing date for responses is 19th December The results of the audit and the prosed new standards and guidelines will be presented at the regional audit meeting on the 15th January 2015 at Marie Curie Hospice, Liverpool. Guideline Development Group for the Management of Nausea and Vomiting in Palliative Care

2 * 1. Information about you: About you What is your role? Where do you work? Which setting do you work in?

3 2. What would be your first line choice of antiemetic for nausea and vomiting due to the following aetiologies? Biochemical Drug induced Psychological Constipation (excluding bowel obstruction) Gastroparesis Antiemetic 3. What would your normal practice be in relation to a patient with nausea and vomiting? (Please select all that apply) Provide advice only History Examination Arrange further investigations eg bloods None of the above Don t know 4. Following your initial review of a patient with nausea and/or vomiting when do you reassess the patient? Within 24 hours 48 hours 72 hours Greater than 72 hours If you don't reassess the patient - why not?

4 5. In which situations would you consider the use of a syringe driver to deliver antiemetics? (Please select all that apply) Symptoms uncontrolled at the time of assessment? If symptoms remain uncontrolled after 24hrs? Loss of appetite without alteration in eating habits Severe nausea and/or vomiting Suspected or known poor absorption Oral intake decreased without significant weight loss, dehydration or malnutrition. IV fluids indicated <24 hrs Inadequate oral caloric or fluid intake; IV fluids, tube feedings, or TPN indicated > 24 hrs 1 vomiting episode in 24 hours 2-5 vomiting episodes in 24 hours > 6 vomiting episodes in 24 hours 6. If nausea and/or vomiting persists do you consider adding a second antiemetic? Yes No 7. What would influence your choice of second antiemetic?

5 8. When prescribing/suggesting antiemetics do you suggest/prescribe the following... Regular antiemetic only PRN antiemetic only Both regular and PRN antiemetic? Suggest 2nd PRN antiemetic? Prescribing basis If no to both regular&prn - why not? 9. Do you experience difficulties in obtaining antiemetics for any of the following reasons? (Please select all that apply) Cost issues Availability of prescriber Obtaining supply of antiemetics from pharmacies out of hours Other

6 10. Is it your practice to suggest or prescribe the following medication for the alleviation of nausea and vomiting? (Please select all that apply) Aprepitant Cyclizine Dexamethasone Domperidone Granisetron Haloperidol Hyoscine Butylbromide Hyoscine Hydrobromide Levemepromazine Lorazepam Metoclopramide Octreotide Olanzapine Ondansetron Prochlorperazine Other

7 11. For the antiemetics listed below please select the maximum doses you suggest and/or prescribe in a 24 hour period and the minimum and maximum stat doses suggested on a PRN basis Maximum dose in 24 hour period Minimum PRN stat dose Maximum PRN stat dose Aprepitant Cyclizine Dexamethasone Domperidone Granisetron Haloperidol Hyoscine Butylbromide Hyoscine Hydrobromide Levemepromazine Lorazepam Metoclopramide Olanzapine Ondansetron Prochlorperazine Other

8 12. Thank you very much for completing this survey. The results will be presented at the January audit meeting. Please feel free to make any comments.