Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

B33CAN - Professionalism & Leadership; Clinical & Pharmacy Practice > Showing compassion and care of the dying > Flashcards

Showing compassion and care of the dying Flashcards

1
Q

How has the hospice movement evolved from its roots to modern day?

A
  • Traditionally based in a ‘care home’ or hospice (as opposed to hospital)
  • 80% care now outpatient/day care, in community and home care settings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the future challenges for the hospice movement?

A
  • Hospices today already support 200,000 in UK
  • Increasingly older population (cancer/other long term conditions)
  • Projected double no. of people > 85 y/o in the next 20 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What defines the hospice movement?

A

‘More than a clinical need’
- Social, spiritual needs as well as physiological/psychological

“There is so much more to be done”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How did the hospice movement shape palliative care?

A
  • Improving QoL of patients and families alike facing a life-threatening illness
  • Prevention and relief of suffering by:
    • Early identification
    •Assessment
    • Treatment of pain
    • Treatment of physical/psychosocial/spiritual needs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How did Dame Cicely Saunders re-shape pain relief?

A
  • Previous practice in 50s/60s was to administer diamorphine (heroin) by injection only in ‘unbearable’ pain relief
  • But became apparent that regular morphine PO provided better pain relief w/no more S/Es, w/no addiction
    »> “Constant pain needs constant control”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is holistic care?

A
  • Considers person as a whole; physically, psychologically, socially and spiritually, in the management and prevention of disease
  • Stemming from concept of link between between physical health and general ‘well-being’; virtuous circle based on trust, building rapport w/patient and family.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why must patient pain be tackled?

A

Associated w/anxiety and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do hospices channel holistic care in their setting?

A
  • Hospices have warm furnishings, sympathetic lighting etc.
  • ‘Home from home’
  • No set ward rounds/visiting times
  • Happy but tranquil environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is meant by the term, pharmaceutical care?

A
  • Holistic approach; not just palliative medicine
  • Legal, moral and professional responsibility; improving patient QoL, or preservation of QoL for as long as possible.
  • “The responsible provision of drug therapy for the purpose of achieving definite outcomes that improve patient QoL”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is medicines optimisation?

A
  • Supporting safe, effective medicines use
  • Not just focus on the medicines; support patient’s experience of taking evidence-based medicines safely
    “Person behind the pills”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are hospices funded?

A
  • NHS (32%)
  • Charities (68%)
  • Privately run (some)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the examples of team-based services that hospices offer?

A
  • Inpatient and respite care (giving carers a needed break)
  • Outpatient and day care
  • Hospital in-reach (inpatients; going into hospitals, recommendation for transfer to hospice etc)
  • Community outreach
  • Bereavement counselling
  • Complementary therapy; aromatherapy, relaxation, Tai Chi etc.
  • Research and education

> > > Offer choices of where patient wants to die.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do charities contribute to the hospice movement?

A
  • Charity shops
  • Clinical care; provide support, information resources, counselling
  • Funding grants
  • Campaigns; policy and advocacy, “Dying matters” campaign etc.
  • Education and research
  • Specialist; improving care worldwide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is “to palliate”?

A
  • To relieve or lessen without curing; to mitigate or alleviate symptoms
    »> Does not necessarily lead to end of life care.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is pain control important (in palliative care/general)?

A

Pain is patient’s greater fear (70%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is pain control achieved in palliative care?

A
  • Pain ladder (stepwise approach; effective in 80-90% of cases), regular dosing etc.
  • Drug, dose titration, formulation, route of administration, dose equivalence
  • Opioid and chronic/specialist pain management, starting doses etc.
  • Syringe drivers to mix compatible drugs (diamorphine used as more soluble than morphine)
17
Q

How is symptoms management achieved in palliative care?

A
  • Adjuvant drugs e.g. steroids (reduce swelling)
  • Treating adverse effects e.g. constipation (give laxatives w/morphine)
  • Dispel myths e.g. addiction
  • Other symptoms e.g. secretions
18
Q

What needs to be considered to ensure patient safety in palliative care?

A

• Prescribing

  • Errors e.g. dose timing (MST is 12-hourly; not 8AM and 6PM as per ward round)
  • De-prescribing drugs of no value (fewer the better; withdraw everything and reintroduce if needs be)
  • Opioid doses, frequency, breakthrough pain

• Preparation
- Syringe drivers; compatibility

• Administration

  • Syringe drivers (similar drivers etc.)
  • Safe use of fentanyl TDD patches (heat induced OD)

• Information

  • Warn patients about S/Es
  • Safe disposal e.g. fentanyl patches; fold in half so irretrievable
19
Q

How is syringe driver safety ensured?

A
  • Syringe drivers composed of several complex medicines given together in a syringe SC
    »> Not to be made up in patient’s kitchen by District Nurse (aseptic unit made-up, then picked up by DN etc.)
20
Q

What was a common (but fatal) administration error w/syringe drivers?

A
  • MS16 and MS26 mix-ups

- MS16 = mm/hr; MS26 = mm/24 hrs (former now withdrawn)

21
Q

Define: anticipatory prescribing.

A

To enable prompt symptom relief at whatever time the patient, develops distressing symptoms; can be predicted and management measures put place in advance.

22
Q

What are the issues with anticipatory prescribing?

A
  • Problems w/accessing medicines out-of-hours causing distress, poor care
23
Q

What medicines are used in anticipatory prescribing, and for what roles?

A
  • Diamorphine injection; pain
  • Midazolam; anxiety/restlessness
  • Haloperidol; nausea/confusion
  • Levomepromazine injection; N&V
  • Hyoscine for SC; xs. respiratory secretions countering ‘death rattle’ - disconcerting for patients
24
Q

How are anticipatory prescribed medicines supplied?

A
  • Agreed drug list (enhanced services in some pharmacies)
  • ‘Just in case’ boxes; for patients to keep at home
    »> Abuse? Inappropriately administered?
25
Q

What are the problems w/anticipatory prescribing?

A
  • Misdiagnosing (symptoms, rate of deterioration)

- Inappropriate administration/disposal

26
Q

What is the ‘Liverpool Care Pathway’, and how did it prove controversial?

A
  • Good intent; best practice, consistency, supporting choice
  • Evaluated best practice from hospice palliative medicine and transferred to general sector setting
    »> Poor practice, lack of information and respect
    »> Failure of proper communication
27
Q

What did the LACDP conclude regarding the Liverpool Care Pathway and future strategies?

A

‘Once chance to get it right’ - Leadership Alliance for the Care of Dying People

  • Shared decision-making and review
  • Sensitive, honest, open communication
  • Patient carer involved in decisions
  • Needs of family respected
  • Individualised patient care plan
28
Q

What is the difference between sympathy and empathy?

A

Sympathy: feelings of pity and sorrow for someone else’s misfortune.

Empathy: ability to understand and SHARE the feelings of another; “put yourself in their shoes”

29
Q

What are the 6 C’s of Care?

A

Care; that people should expect
Compassion; care delivered with
Competence; and expertise to deliver care
Communication; effectively w/patient and carers
Courage; doing the right thing
Commitment; stick with it, to improve care for patients

> > > Nursing principles applicable to all HCPs

30
Q

What is the truly care for the patient?

A
  • To listen to what a patient has to say and to understand them; not just give a reply
  • Sense that HCP matters and that we can be trusted, building rapport w/patient
  • Empathy, not sympathy
  • 6 C’s
  • Putting the patient first
    #hello my name is campaign (HCPs more personable)

B33CAN - Professionalism & Leadership; Clinical & Pharmacy Practice (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions