Community Health Nurse
Introduction
Palliative care is a specialty of medicine that is concerned with the enhancement of the quality of life of individuals and families of individuals that are battling with a serious illness. Its major focus is on the increase of comfort by expert management of distressing symptoms including treatment and prevention. In addition, palliative care is also geared towards a better care plan through clear communication, proper planning and impeccable coordination of care (Supuileda, 2002). Palliative care involves the whole individual. It involves caring for the physical, emotional and spiritual needs of the individual and their families. It focuses on the relief of pain, management of other symptoms like fatigue, insomnia, nausea, loss of appetite and shortness of breath.
Palliative care is usually provided by a team of health professionals. The team includes palliative care physicians, palliative care specialists, general practitioners, nurses, social workers, and therapists, including physical therapists, occupational therapists and speech therapists. Palliative care can be rendered either in a hospital setting, an outpatient clinic or even at the patient’s residence (Supuileda, 2002).
Purpose of the program
The purpose of this program is to expand the existing palliative care program that the hospital already provides. Under the current setting, palliative care is provided to patients who need them in the wards where they are admitted primarily for the treatment of their ailment. For example, an oncology patient is given palliative care in the oncology unit. However, with an expansion of the palliative care program, there would be an establishment of a Palliative care Unit where all patients that require palliative care are cared for. The palliative care would still be rendered as an in-hospital setting but this time around, it would be in a specialized palliative care ward.
Target population
The target population includes all individuals that require palliative care. Individuals that have a clinical diagnosis and a limit to the number of years they still have to live, require palliative care. Traditionally, the belief is that only cancer patients require palliative care, however, it is clear that other group of patients also require palliative care. They include patients with heart disease, cerebrovascular accident, neurological disorders to mention just a few. In short, any one that thinks they need palliative care is qualified for it.
Benefits of the program
This expanded palliative care program would be beneficial to patients, caregivers and health care professionals alike. To the patients, they would be able to receive palliative care in a structured system. Irrespective of the diagnosis, the needs of all palliative care patients are similar. They are all united by the fact that they have a limited amount of years to live, they also suffer from one form of discomfort or the other. By putting all palliative care patients together in one single unit, their common needs can be catered for. In addition, it would be easier to implement common interventions that would improve their quality of life. For their relatives, they would also be in close contact with the patient as the environment would be different from the normal set up of an in-patient ward. The setting would be more homes friendly so that the patient would feel more comfortable in a familiar environment as opposed to being in an intensive-care unit, an emergency department or even an in-patient ward. For health care professionals, it would also be a good opportunity to provide for the needs of this group of patients while monitoring them. Evaluation would also be easier and the program modified according to the outcome of periodic evaluations.
Justification
There is a dire need to improve the quality of end-of-life patients. Patients that have a short period of life to live should be given the best care they can get in order to alleviate their symptoms so that they spend the rest of their life in the best healthful way they can get. It is also desirable that they spend this period thinking less about their medical condition and its complications and focus more on living a peaceful and trouble free life. This set of individuals should also spend the rest of their lives in close proximity to relatives, if they so wish. With all the aforementioned, the best way to realize these aspirations is to have a specialized form of care for them, rendered in a specialized unit.
Evaluation
In evaluating the success of this program, several methods can be used. The satisfaction of patients can be gauged by periodic administration of questionnaire in which the patients are asked about the effectiveness of the program. They are asked questions about the appropriateness of the interventions being given to them to know if they are satisfied with the program. In addition, their relatives can also be interviewed to know if they are also satisfied with the level of care that their relatives are getting (Higginson, 2010).
The healthcare professionals caring for them can also be evaluated periodically to see if the program protocol is being followed at all times (Ellershaw, 1995). In addition, suggestions about improvement can be sought from the patients, their relatives and the health care professionals alike.
References
Ellershaw J et al (1995). Assessing the effectiveness of a hospital palliative care team. Palliat Med. 1995 Apr;9(2):145-52. Accessed on 1st June, 2012 from http://www.ncbi.nlm.nih.gov/pubmed/7541684
Higginson, I J (2010). What Is the Evidence That Palliative Care Teams Improve Outcomes for Cancer Patients and Their Families?. Cancer Journal: September/October 2010 - Volume 16 - Issue 5 - pp 423-435. doi: 10.1097/PPO.0b013e3181f684e5
Cecelia Sepuilveda et al (2002). Palliative Care: The world Health Organization's Global Perspective. Journal of Pain Symptom and Management. Vol 24 No 2. 91-96. Program on Cancer control and Essential Drugs and Medicines Policy, World health Organization, Geneva, Switzerland.
