Table of Contents
Introducing the concept of palliative care.
Target Audience and rationale.
Objectives and outcomes.
Principles of palliative care.
Implementation of the principles.
The providence of end of life care is one of the major domains associated with the practice of professional nursing. In most of the cases, the caregivers have to have interdisciplinary skills in nursing to manage complicated and multiple health ailments of the patients. The purpose of this study is to look into the principles and guidelines tagged with palliative nursing in the land of Australia.
The physical, clinical and the psychological condition of the aged patients demand the support of nursing and this is specifically associated with the principles of geriatric nursing. As per the idea of Avati et al. (2018), providence of relief from distressing symptoms and pain is the most important factor tagged with the principles of palliative care. At the national level of Australia, initiatives have been taken regarding the structuring of the service development guidelines for safe and high-quality palliative care. As per the official report, around the globe, 40 millions of people have a demand for palliative care among which majority of them are associated with such nations with middle and low income-level (who.int, 2020). The clinical issues include end-stage chronic illness, slow degeneration of multiple organs or multiple organ failure, high frailty of age, cancer or drug resistance diseases.
The third year undergraduate students of nursing along with practicing and registered nurses are the target of this study. They should have a conspicuous idea about the providence of multidisciplinary care to the aged patients as end to life care. The official report reveals that only 14% of the entire population who demand palliative care is getting the same. Hence, from this angle, it can be analysed that the aspect of geriatric nursing is still needed to be developed. Additionally, the unnecessary regulation over the use of the drugs like morphine creates hindrance in the process of pain management of palliative care. It has been identified that 80% of the aged patients with cancer of AIDS and 97% of CVD (cardiovascular disease) patients suffer from excruciating to moderate pain at the terminal stage of their lives (who.int, 2020). All these factors have acted as rationale to restructure the guidelines of palliative care by AIHW (Australian Institute of Health and Welfare) and PCA (Palliative care Australia).
The aim of this paper is to analyse the current structure of Australian palliative care and to promote the matter to provide better quality of end to life caregiving for the patient who needed the same.
In Australia, the guidelines provided by PCA have been approved by the Commonwealth health ministry. The analysis of the symptoms of the patient and minimisation of physical suffering of the same should be the key aim of palliative care (palliativecare.org.au, 2018). In Australia it has been noticed that 50% of people take their last breathe at the hospital while the rest 50% at their home. Hence, the arrangement of the set-up for palliative care can be equally done at home. However, Watson (2019) has stated that the promotion of person centred care is highly needed for end life caregiving. Designing a person-centred nursing framework and providence of psychological support through spiritual and affirmative approach is necessary in major cases. The analysis of cognitive symptoms is needed along with the evaluation of the medical history of the patient.
The implementation of the major goals in the process of caregiving is highly necessary. As per Krcevski‐Skvarc, Wells & Häuser (2018), minimisation of pain with the implementation of the best possible clinical method is the primary goal of palliative care. Additionally, treatment of the symptoms of the patient and improvement of the health to the possible extent should be done. von Blanckenburg & Leppin (2018) has mentioned that meaningful interaction with the patient and assistance in the process of safety and mobility should also be at the focal point of the caregiving process.
Local government and state has an active role in the promotion of the availability of palliative care at the community level and this is the primary step of implementation of the guideline of palliative care followed in Australia. The official report has transparently mentioned that in the availability of funds for palliative care, the territory government should take initiatives (palliativecare.org.au, 2018). On the other hand, Masso et al. (2015) has mentioned that the concern and contribution of the family of the patient have a role in the implementation of high quality palliative care. The national statistics of Australia proves that 2.7 millions of individuals are associated with palliative caregiving among them 96% are providing care for their family members (alliativecare.org.au, 2018). This needs to be further promoted to get better outcomes. .
At the end of the study, it can be concluded that palliative care demands multidisciplinary skill of the caregiver and person-centred caregiving as well. However, it has been noticed that the rate of obtaining proper palliative care is not at all appreciable in the global context. Australian health ministers along with PCA have developed a well-structured guideline with 4 major goals of palliative caregiving, to improve the standard and rate of geriatric nursing.
Avati, A., Jung, K., Harman, S., Downing, L., Ng, A., & Shah, N. H. (2018). Improving palliative care with deep learning. BMC medical informatics and decision making, 18(4), 122. Retrieved on 9 August 2020, from: https://link.springer.com/article/10.1186/s12911-018-0677-8
Hudson, P., Trauer, T., Kelly, B., O'Connor, M., Thomas, K., Zordan, R., & Summers, M. (2015). Reducing the psychological distress of family caregivers of home based palliative care patients: longer term effects from a randomised controlled trial. Psycho‐Oncology, 24(1), 19-24. Retrieved on 9 August 2020, from: https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.3610
Krcevski‐Skvarc, N., Wells, C., & Häuser, W. (2018). Availability and approval of cannabis‐based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation. European Journal of Pain, 22(3), 440-454. Retrieved on 9 August 2020, from: https://onlinelibrary.wiley.com/doi/abs/10.1002/ejp.1147
Masso, M., Allingham, S. F., Banfield, M., Johnson, C. E., Pidgeon, T., Yates, P., & Eagar, K. (2015). Palliative care phase: inter-rater reliability and acceptability in a national study. Palliative medicine, 29(1), 22-30. Retrieved on 9 August 2020, from: https://journals.sagepub.com/doi/abs/10.1177/0269216314551814
palliativecare.org.au, (2018), Palliative Care Service Development Guidelines-2018. Retrieved on 9 August 2020, from: https://palliativecare.org.au/wp-content/uploads/dlm_uploads/2018/02/PalliativeCare-Service-Delivery-2018_web2.pdf
von Blanckenburg, P., & Leppin, N. (2018). Psychological interventions in palliative care. Current opinion in psychiatry, 31(5), 389-395. Retrieved on 9 August 2020, from: https://journals.lww.com/co-psychiatry/FullText/2018/09000/Psychological_interventions_in_palliative_care.3.aspx
Watson, M. (2019). Oxford handbook of palliative care. Oxford University Press, USA. Retrieved on 9 August 2020, from: https://books.google.com/books?hl=en&lr=&id=XmCpDwAAQBAJ&oi=fnd&pg=PP1&dq=palliative+care&ots=5krZEfrW0W&sig=x7MY8eggpSYpSWWyfARnF2wziBM
who.int, (2020). Palliative Care. Retrieved on 9 August 2020, from: https://www.who.int/news-room/fact-sheets/detail/palliative-care#:~:text=Each%20year%2C%20an%20estimated%2040,palliative%20care%20currently%20receive%20it.
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