Challenges and choices: an audit of the management of nausea, vomiting and bowel obstruction in metastatic ovarian cancer.

Women living with metastatic ovarian cancer experience many distressing symptoms, such as vomiting and bowel obstruction, which challenge the expertise of nurses working in Palliative Care to promote quality of life. These clinical challenges prompted us to audit our management of nausea/vomiting and bowel obstruction in a New Zealand Palliative Care service, with a focus on both pharmaceutical and non-pharmaceutical interventions (e.g. dietary advice, relaxation strategies). The audit involved a retrospective chart review of 17 patients and identified the current clinical management of these symptoms in comparison with best practice guidelines. The results indicated many areas of symptom management were in line with current evidence-based practise; however the use of non-pharmaceutical interventions was limited. There were several implications for clinical practice, specifically supporting the use of electronic integrated patient management systems and a greater use of nonpharmaceutical (complementary) interventions. The audit process provided useful data for the authors to analyse current practice and promote more effective management of these distressing symptoms.