NURSE-UN 1243 Adult and Elder Nursing 3 Week 8 Caring for Patients with Serious Illness and End-of- Life,100% CORRECT
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NURSE-UN 1243
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NURSE-UN 1243
NURSE-UN 1243 Adult and Elder Nursing 3 Week 8
Caring for Patients with Serious Illness and End-of- Life
Objectives
● Demonstrate clinical decision making based on the integration of information from multiple sources, including the patient, inter-professional team, & the best available evide...
nurse un 1243 adult and elder nursing 3 week 8 caring for patients with serious illness and end of life
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NURSE-UN 1243 Adult and Elder Nursing 3 Week 8
Caring for Patients with Serious Illness and End-of- Life
Objectives
● Demonstrate clinical decision making based on the integration of
information from multiple sources, including the patient, inter-
professional team, & the best available evidence for patients with
serious illness and at end-of-life.
● Advocate for high quality, safe, & culturally competent patient
centered care for hospitalized patients with serious illness and
at end-of-life.
Experience with Death
● Consider your own…
○ Personal experiences with death?
○ Experience with death in your family?
○ Past clinical experience with death?
What is a “Good Death”? -It's very subjective
● prepared, natural causes, time to speak to the person who is
dying, keeping dignity, staying with loved ones, keeping the
patient comfortable, knowing where you are in the disease
process
Serious Illness
● Refers to any disease or event (such as an accident) that is unlikely
to be curable and is life-limiting.
● Approximately 90 million people in America are living with a
serious illness (CAPC, 2013)
● 86% of the $3 trillion in annual US healthcare expenditures is
spent on meeting challenges of chronic disease (CDC, 2016)
● Little attention and financial support has gone to maintaining or
enhancing quality of life for these patients with chronic, serious
illness (IOM, 2012).
Talking About Serious Illness
● Assessment first!
o “What is your understanding of your illness?”
● Open ended questions
, o“What are you most concerned about?” - family, children, unfinished
business
● Reflecting/Validating:
o “It seems like…”
● Therapeutic Use of Silence -
and listen You don’t have to have all
the answers!
,Palliative Care :Symptom management of a chronic condition. Could also
get treatment for cureative conditions.
● Patient-and family-centered care that optimizes quality of life by
anticipating, preventing, and treating suffering.
● Palliative care throughout the continuum of illness involves
addressing physical, intellectual, emotional, social, and spiritual
needs and to facilitate patient autonomy, access to information,
and choice.
The Palliative Care Team
● Has become an essential component of quality care in hospitals across the US.
● Currently, 90% of hospitals with more than 300 beds and 96% of
teaching hospital have palliative care teams (CAPC, 2015)
● Your role as a nurse is to advocate for patient access to the team
and work with the team to develop a plan of care that is consistent
with the patient’s
wishes.
● assess what the patient needs and what are their wishes
Palliative vs comfort care
comfort care is a lay term (not an official term)
palliative care= symptom management of a chronic or
terminal illness (can be on this for many years); can be
getting treatment for curative care
Hospice (estimated life expectancy of 6 months or less)
● more a service than a place; end of life
● A model for quality, compassionate care for people facing a life-
limiting illness or injury, hospice care involves a team-oriented
approach to expert medical care, pain management, and emotional
and spiritual support expressly tailored to the patient's needs and
wishes.
● Support is provided to the patient's loved ones as well.
● At the center of hospice and palliative care is the belief that each of
us has the right to die pain-free and with dignity, and that our families
will receive the necessary support to allow us to do so.
● https://www.nhpco.org/about/hospice-care
, ● Under the Medicare Hospice Benefit, patients sign off their Medicare
Part A—they chose to receive hospice care rather than disease-
modifying treatments.
● Hospice care focuses on caring not curing.
● focus for hospice care is comfort and pain management
o **Test tip: ABCs are not a priority for hospice care; priority
is comfort and pain management
o must have a life expectancy of less than 6 months, no longer
pursuing curative treatments, need 2 provider signatures, can
withdraw from hospice if needed.
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