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Managing Psychological Issues Inclusive of Terminal Restlessness

Introduction to Palliative Care Service Development

As described by the school of medicine, palliative care is an approach, which enhances the quality of life of individuals experiencing problems linked with life-threatening diseases via the relief and prevention of suffering (Australia, 2018). It is usually done employing early identification and perfect evaluation and treatment of pain and some other problems such as physical, mental, and different types of tumors. Palliative care has some distinct kinds which are available and given by qualified nurses. They include; social, physical, mental, and mental (Australia, 2018). When dealing with palliative care, the palliative doctor might prescribe medications and other pain treatments, shortness of breath, constipation, and other symptoms. A social worker can also coordinate the patient’s care and act as an advocate on behalf of the patient’s family. Clinical Practice Guidelines (CPG) is logical developed statements used to assist patient and practitioner decisions about the appropriate health care for specific situations (Pugliese et al., 2019). They also offer concise instructions on which screening and diagnostic tests can be conducted. These tests are typically done to order how palliative will be administered to the respective patient. CPG is also used to reduce unsuitable variations in practice, promoting high-quality palliative care, and evidence-based health care. There are some benefits of CPG that help patients and practitioners to uphold their usage (Pugliese et al., 2019). One of the most services is to improve the quality of care delivered to patients. Another benefit is to help improve the health care results obtained from the palliative doctors. Through these guidelines, we can maintain high levels of care as they reduce mortality and morbidity, improving the quality of life for some health conditions.

The reduction of mortality and morbidity is made easy by using guidelines that promote proven benefit and dampen unsuccessful ones (Tan et al., 2020). Throughout the paper, the management of psychological problems will be our theme. This essay's primary purpose is to provide a comprehensive critique of managing psychological issues, especially terminal restlessness guidelines as the chosen Clinical Guidelines Principle. In this essay, you will find the pros and cons of Frank’s care given to him and his family. Frank is currently in a critical health situation as he is suffering from Glioblastona Multiforme and urinary discomforts. He is now hospitalized in a nearby hospital where he can visit his home, and the family members can easily access him. Frank was sent for further scanning and was discovered that his spinal cord is compressed. This is known as drop metastasis in which the cellular is spread within the subarachnoid space travels.

Terminal Restlessness Guidelines

A terminal restlessness guideline is the chosen CPG where different standards will be presented, especially their importance to our health care practice and the given Frank’s case. This CPG is significant to Frank’s case as it will help improve the quality of palliative care delivered to Frank, hence enhancing his life. The standards review in the essay includes palliative care standards, NMBA standards, and NSQHS standards. These standards serve as essential guidelines to the doctors, patients, and nurses in their respective professions and offices. In NMBA, these standards help patients, caregivers, and service users receive clinical-based care. Secondly, NMBA standards enable patients to be accountable for their care and know that they will be cared for consistently in an evidence-based manner. The last benefit obtained from abiding with these standards is that patients can improve their health and later prevent other diseases.

On the other hand, the main objective of NSQHSS (National Safety and Quality Health Service Standards) is to ensure that the public is protected from harm and that health service provision is enhanced (Pereira-Salgado et al., 2017). Therefore, the first benefit is that these standards provide a quality assurance mechanism to ensure relevant systems are available to meet the desired safety and quality service. Another advantage is that helps the health services providers to perform several staffs, including; improving health and safety in the workplace, determining efficiency, determining the appropriate type of care to be offered, and also identify some gaps in their current health systems (Scanlon et al., 2016). These standards help them be updated to health issues such as; the level of quality to ask for from their caregiver, putting a human face to health care providers. They provide active feedback on their current services delivered to help the providers identify some relevant gaps. Lastly, palliative care standards also offer a number of benefits to the concerned stakeholders, i.e., doctors, patients, nurses, and health services providers (Scanlon et al., 2016). The standards benefit these stakeholders in ensuring that a patient is attended to appropriately and given the required treatments. They also ensure that the quality of palliative care services is enhanced and, therefore, improves the patients' lives. These standards are instrumental and provide the basis for the best health care services provision. The public and several nations consider these standards. They also match with our CPG principles are the directions given to ensure high-quality health care is provided to the victims. They influence our practice in palliative care and any other medical field by prescribing the guidelines to follow. Through following the principles provided by these standards, health care services are well improved and delivered in the best quality ever. When an individual is nearing death, he/she experiences terminal restlessness as a common symptom. It is also known as terminal agitation, which mostly includes confusion, anxiety, and fever.

An individual facing these signs feel intense, more than simple mood changes. It is sometimes interpreted to be a sign of death, and it can be very troubling to the family members of the suffering individual. GBM (Glioblastona multiforme) is another adult-related problem. Brain cancer is mostly found in aged fellows. It is one of the fast-growing tumors in the world (Bennett et al., 2016). Its cancerous cells spread quickly inside the brain, which makes it hard possible to remove surgically altogether. Although it is commonly found in the mind, this cancer has been, in some cases, found I bone, lungs, neck, liver, and lymph node (Bennett et al., 2016).

Pros of Frank’s Care

Throughout Frank’s care process, there are notable pros. Frank was given the best pressure injury care in Braden score pressure mattress. This was a high-quality health care service provided to Frank, considering the current situations he was experiencing. Other pros are that he was tested using the most modern systems to proved evidence-based diagnostic results to the family and himself. The results were well presented and explained to the family to facilitate appropriate care while at home. The family was well educated about restlessness and its effect on the suffering of individual and family members. Referring Frank to another diagnostic test was a favorable decision by the doctor. It demonstrated the need to verify the test outcomes and make the suitable decision on the kind of palliative care to be delivered to Frank (Levett-Jones et al., 2018). On arrival at the hospital, Frank was welcomed, and orientation to the ward was done. The areas of care and assessment that were given to Frank match our Clinical Practice Guidelines. They include; pain assessment, the taking of NOK details, Falls risk assessment, Braden Pressure assessment, and allied health referrals. These care and evaluation areas aim to ensure high-quality palliative care services are delivered to Frank and his family. Due to that fact, they match our Clinical Practice Guidelines, managing psychological issues because both Frank and his family were mentally disturbed. They needed some to take palliative care guidelines to help manage their situation, so this doctor successfully did. Therefore, the respective hospital that dealt with Frank’s health circumstance has highly trained and motivated health service personnel (Scanlon et al., 2016).

Cons and Limitations in Frank’s Care

Despite Frank’s care having several pros, it has some notable cons. One of the cons is that he could participate in the orientation instead of giving the necessary first-aid practices. This was a discouragement to his family as it was worried and confusing too. When the doctor gave information about further scans to the family was not ideal as this could cause more tumor and pain to the patient (Frank). Also, to the family, it creates anxiety about the results of the next diagnostic scans. There some areas of care and assessment that are in our CPG but not included in Frank’s care: which include reviews such as the patient’s occupational history, presentation of prior surgical history, possible violent risk assessment, and the educational history. All these areas and assessments could have given the health care service providers an easy time to know where and what to start with (Song, 2016).

Missing Areas of Care and Assessment in Terminal Restlessness Guidelines

Although our CPG (terminal restlessness guidelines) has powerful and useful care areas and assessment, it has some missing aspects. Those missing elements, when applied to Frank’s care, it would produce good care too. The first absent assessment is delirium screening. It is the most crucial scanning system for a person with terminal restlessness (Halcomb, L2018). When a health service provider uses this scan, it becomes easy for that officer to deliver the appropriate instructions to the nurses, patients, and the family. Things like encouraging the patients to rest and sleep, keeping their room quiet, ensuring their conformability, and helping them to eat are appropriately directed when the delirium test is done. Another missing assessment that could help Frank’s care is the need to get information on the patient's prior surgical history to identify the results, screening done, mistakes made, the medication prescribed, and other relevant findings. These two areas of care and assessment deserve to be integrated into terminal restlessness guidelines to improve their efficiency and enhance patients' lives suffering from terminal restlessness (Oldland et al., 2020). Their addition to terminal restlessness guidelines will improve the palliative care delivered to Frank’s care and enhance the intensity of screening to the respective hospitals and improve reliability and trust to the health care service providers.

Conclusion on Palliative Care Service Development

In conclusion, terminal restlessness, as a common symptom when an individual is nearing his/her last days (Hains et al., 2017). It is also known as terminal agitation, which mostly includes confusion, anxiety, and rage. An individual facing these signs feel intense, more than simple mood changes. In some circumstances, it is interpreted to be a sign of death, which can be very troubling to the suffering individual's family members. Terminal restlessness guidelines are useful in managing the psychological issues of the patient and the family. It has critical care and assessment areas that guide the health officers to offer high-quality palliative care services. In Frank’s case, Terminal restlessness guidelines helped the health care providers deliver the required care and give appropriate instructions to his family. However, delirium screening was among the missing areas of care and assessment, which is very powerful and comprehensive. I recommend integrating this scan into Terminal restlessness guidelines to improve palliative care quality delivered to patients suffering from terminal agitation (Croft et al., 2018).

References for Palliative Care Service Development

Australia, P. C. (2018). National palliative care standards. Canberra: Palliative Care Australia.

Australia, P. C. (2018). Palliative care service development guidelines. ACT: Australia PC.

Bennett, S. R., Cruickshank, G., Lindenmeyer, A., & Morris, S. R. (2016). Investigating the impact of headaches on the quality of life of patients with glioblastoma multiforme: a qualitative study. BMJ open6(11).

Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T., & Schneider, J. (2018). Thinking in pharmacy practice: a study of community pharmacists’ clinical reasoning in medication supply using the think-aloud method. Pharmacy6(1), 1.

Hains, T., Turner, C., & Strand, H. (2017). The non-medical surgical assistant in Australia: who should contribute to governance?. Australian Journal of Advanced Nursing, The35(2), 51.

Halcomb, L. (2018). How an understanding of paradigms can improve the quality of nursing research. Nurse Researcher (2014+)25(4), 6.

Levett-Jones, T., Reid-Searl, K., & Bourgeois, S. (2018). The clinical placement: An essential guide for nursing students. Elsevier Health Sciences.

Oldland, E., Botti, M., Hutchinson, A. M., & Redley, B. (2020). A framework of nurses’ responsibilities for quality healthcare—Exploration of content validity. Collegian27(2), 150-163.

Pereira-Salgado, A., Boyd, L., & Johnson, M. (2017). Developing online accreditation education resources for health care services: An Australian Case Study. International Journal for Quality in Health Care29(1), 124-129.

Pugliese, M., Voslarova, E., Biondi, V., & Passantino, A. (2019). Clinical Practice Guidelines: An Opinion of the Legal Implication to Veterinary Medicine. Animals, 9(8), 577.

Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of defining nurse practitioner scope of practice in the Australian context. Collegian23(1), 129-142.

Song, W. J. (2016). 'Caring'a an understanding of professional identity by first-year nursing students. Whitireia Nursing and Health Journal, (23), 37.

Tan, H., Rumbold, B., Gardner, F., Snowden, A., Glenister, D., Forest, A., ... & Wyles, L. (2020). Understanding the outcomes of spiritual care as experienced by patients. Journal of Health Care Chaplaincy, 1-15.

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