1. Palliative Care Presented By: Mya Bentley, Shauntelle Farden, and Megan Kassel

2. What does Comfort Care mean to you? Has anyone had any experience with comfort care?

3. Definition: Palliative care means 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 to facilitate patient autonomy, access to information, and choice.

4. Palliative care population Chronically ill patients (this includes children, neonates, and the elderly) Patients with life threatening injuries that depend on life sustaining treatments Neonates, children, adolescents with developmental and intellectual disabilities who develop serious or life threatening illness. Underserved and vulnerable, and under-resourced people with low income, oppressed racial and ethnic groups, veterans, prisoners, older adults, and individuals with mental illness.

5. Evidence Based Practice Research Palliative care improves quality of life for patients and their families. Private foundations continue to be important funding source for research in this area. However increase federal funding is needed to improve research. Further development of palliative care with the passage of the Patient Protection Care Act and Affordable Care Act of 2010 (PPACA).

6. Name 3 ways palliative care can meet the needs of the patient and their family.

7. National Census Project for Quality Palliative Care Domain 1: Structure and process of care Domain 2: Physical aspects of care Domain 3: Psychological and psychiatric aspects Domain 4: Social aspects of care Domain 5: Spiritual, religious, and existential aspects of care Domain 6: Cultural aspects of care Domain 7: Care of patient at the end of life Domain 8: Ethical and legal aspects of care

8. Name 3 domains of palliative care?

9. Do you think palliative care is the same in every hospital?

10. Auburn Hospital’s Policy & Procedure Policy Statement: Comfort care orders are intended for use in end of life care when a decision has been made that the primary goal of care if promotion of comfort, not cure or life prolongation.

11. ACH’s approach to comfort care Patient must have DNR (Do Not Resuscitate) order in place Ensure medication are ordered to include analgesics, opioids, sedatives, antipyretics and medications for secondary symptoms Provide mouth care for comfort; this should be done at a minimum of every 2 hours. Turn and position patient at a minimum of every two hours, assess patient comfort level every hour during hourly rounds. Liberalize visiting hours for the family, educate family how they can best assist with care of patient.

12. Upstate Hospital’ s Palliative Care Services Purpose/Scope: Palliative care services offers an interdisciplinary approach to provide adult patients and their families experiencing serious, chronic, or terminal illness the following: Emotional support End of life support Decision making consultation Hospice referrals Advanced directives Discharge planning and Grief & Bereavement

13. After learning about two particular hospitals approach on comfort care, do you think that Palliative Care is the same in every hospital?

14. QSEN & National Patient Safety Goals In comparison we feel that ACH’s policy and procedure reflects efforts made to address meeting National Patient Safety Goals. On the flip side we that Upstate Hospital could benefit from an updated policy that incorporates well defined, and measurable interventions needed to care for Comfort Care patients.

15. Our Philosophy on Comfort Care Care is provided and services are coordinated with an interdisciplinary effort in mind. Patients, families, and collaborative team will communicate about care of the patient and family. Lastly, patient and family hopes for peace and dignity are supported throughout the course of illness, during the dying process, and after death.

16. Resources for Comfort Care Palliative Care in New York · Matthew House in Auburn, NY · Emeritues at West Side Manor in Liverpool, NY · Emeritus at East Side Manor in Fayetteville, NY · Emeritus at Bellevue Manor in Syracuse, NY Online Sources for Nurses · Hospice & Palliative Nurses Association. http://hpna.advancingexpertcare.org/ http://hpna.advancingexpertcare.org/ · World Health Organization. http://who.int/cancer/palliative/en/ http://who.int/cancer/palliative/en/ · American Association of College of Nursing. http://www.aacn.nche.edu/elnec http://www.aacn.nche.edu/elnec

17. Name one local resource that provides palliative care

18. Video http://youtu.be/lDHhg76tMHc