Sample assessment tool -- Observation and demonstration checklist Knowledge questions Part A – Descriptive questions: 1. Discuss ways an enrolled nurse could identify needs of the person in palliative...

Sample assessment tool -- Observation and demonstration checklist



Knowledge questions

Part A – Descriptive questions:

1. Discuss ways an enrolled nurse could identify needs of the person in palliative care, and their family or carers, when providing palliative care support to them. Include in your response examples of specific assessment tools a nurse may use and common needs and preferences they must identify.
While conducting the assessment of the needs, the information can be collected through the examination of the medical history, discussions with the members of the family as well as the prior analysis of the condition of the patient (Pidgeon et al., 2018). The tools that can be used here can be documentation and notes.
Source:
Pidgeon, T. M., Johnson, C. E., Lester, L., Currow, D., Yates, P., Allingham, S. F., ... & Eagar, K. (2018). Perceptions of the care received from Australian palliative care services: A caregiver perspective. Palliative & supportive care, 16(2), 198
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2. Explore and discuss legislation on advance care planning, advance care directives and notification of a death in your State/Territory in relation to a person admitted in a hospice/aged care facility/ hospital setting.
Include in your responses an enrolled nurse’s role in applying the legislation.
Victorian legislation now accepts directives to advised care planning in which, prior consent of the patient and his family members has to be valued in order to proceed with the process of care (Batchelor et al., 2019). It is one of the major factors, which the nursing professional must keep in mind regarding the way, the value of the process of treatment is perceived by the patient and the way, in which they are willing to respond to a particular process of care.
Source:
Batchelor, F., Hwang, K., Haralambous, B., Fearn, M., Mackell, P., Nolte, L., & Detering, K. (2019). Facilitators and barriers to advance care planning implementation in Australian aged care settings: a systematic review and thematic analysis. Australasian journal on ageing, 38(3), 173-181.
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3. Discuss diverse cultural, religious and spiritual factors underpinning the person’s choices at end-of-life using appropriate examples. How is this understanding vital in providing nursing care?

While end of life nears the patient, the choices of the person should be respected on behalf of the nursing professional (Chan, Molloy, Pertile & Iglesias, 2017). The cultural beliefs and practices about the religion have a lot to infer when the end time nears. The process of care should be guided by the principles of the culture and religion of the patient as well.
Source:
Chan, A., Molloy, L. J., Pertile, J., & Iglesias, M. (2017). A review for Australian nurses: Cannabis use for anti-emesis among terminally ill patients in Australia.
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4. Discuss the following ethical and legal issues related to a palliative care approach:
· Decisions regarding advance care directives
· Conflicts that may occur in relation to personal values and decisions made by or for the person ▪ Organ donation
· Request for autopsy
How could each of these ethical and legal issues affect your nursing practice?
Decisions of the advised care directives should be aligned with the new legislations, as applicable since March 2018 (Carey et al., 2019). At the same time, the personal values of the patient having palliative care should be valued with integrity and confidentiality. The organ donation or the request for autopsy is to be managed through prior consent of the patient as well as its approval on behalf of the hospital authority as well.
Source:
Carey, M. L., Zucca, A. C., Freund, M. A., Bryant, J., Herrmann, A., & Roberts, B. J. (2019). Systematic review of barriers and enablers to the delivery of palliative care by primary care practitioners. Palliative medicine, 33(9), 1131-1145
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5. Briefly describe the hydration and nutrition requirements of an adult patient during palliative care and at end-of-life. Discuss ways a nurse could address the hydration and nutrition requirements of the patient when providing palliative care or end of life care.

Hydration and nutrition requirement are subjected to the choices made by the adult patient having end of life care options (Khalil, Downie & Ristevski, 2019). There can be leverages taken at this sensitive time by respecting the food choices and intake of the hydrated material that the patient requests. It has to be the part of the regular monitoring and medication as well.
Source:
Khalil, H., Downie, A., & Ristevski, E. (2020). Mapping palliative and end of care research in Australia (2000–2018). Palliative & supportive care, 18(6), 713-721
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6. Discuss the use of syringe driver and intima sub-cut lines in administering analgesic medications for a patient receiving palliative care or end of life care. Include in your answer:
· Examples of analgesics administered using a syringe driver or intima sub-cut lines.
· Indications and contraindications for use of syringe drivers in administration of pain medication.
· Indications for intima sub cut lines for pain relief, anti-nausea and steroid injections.
· Role of an enrolled nurse in administering medications via a syringe driver or intima sub-cut lines.

Syringe drivers and in time sub cut lines are used to provide pain relief. However, they have certain limits and restriction especially in the context of end of life care options taken by the patient (Luckett et al., 2014). The analysis of the situation and the anticipation of the patient are subjected to be managed and processed in this context because not always, pain relief is an option, which can be granted to the patient.
Source:
Luckett, T., Phillips, J., Agar, M., Virdun, C., Green, A., & Davidson, P. M. (2014). Elements of effective palliative care models: a rapid review. BMC health services research, 14(1), 1-22
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7. Discuss common non-pharmaceutical and complementary care in pain management for a patient receiving palliative care or end of life care using examples.
The complimentary care options are recommended in case the medication, which is primary, is not functional in end of life (Reid et al., 2019). Complimentary plans of care are designed to make sure that the tentative relief alternatives are being given to the patient. For example, increasing the visiting hours of the family members for such patients can be complimentary for a short period.
Source:
Reid, E. A., Kovalerchik, O., Jubanyik, K., Brown, S., Hersey, D., & Grant, L. (2019). Is palliative care cost-effective in low-income and middle-income countries? A mixed-methods systematic review. BMJ supportive & palliative care, 9(2), 120-129
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8. Discuss the impact of loss and grief on the person receiving palliative care and their family or carers. How could a nurse manage these impacts?

Loss and grief is predestined in the context of end of life care option taken by the patient. The nursing professionals contribute significantly in the process of taking care of the loss and grief of the family members by convincing them about the degree of care that is already given to the patient (Brereton et al., 2017). The impacts can be managed through detailing the treatment options, which were given to the patient.
Source:
Brereton, L., Clark, J., Ingleton, C., Gardiner, C., Preston, L., Ryan, T., & Goyder, E. (2017). What do we know about different models of providing palliative care? Findings from a systematic review of reviews. Palliative medicine, 31(9), 781-797
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9. Discuss the impact of loss and grief on nurses and other team members. How could they manage these impacts?

While working with a patient having palliative care, the nurses are mostly aware about the consequences (Vuksanovic, Green, Dyck & Morrissey, 2017). To manage the loss and grief in such contexts, it is important to sustain mental peace and calm. They have to keep their professional strength upright so that they can work further with the provided case. At the same time, they have to convince their team members on personal level that they could give their best in the process of care.
Source:
Vuksanovic, D., Green, H. J., Dyck, M., & Morrissey, S. A. (2017). Dignity therapy and life review for palliative care patients: a randomized controlled trial. Journal of pain and symptom management, 53(2), 162-170
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10. Identify and briefly describe three (3) relevant resources available to those requiring grief and bereavement support in your State or Territory.

The three resources are mental, physical and spiritual support. At mental level, the support exists in the form of external convincing and consolation received on behalf of the senior team members (Kaasalainen et al., 2019). At physical level, a slight break from the duty can be given and at spiritual level, the nursing professionals are given spiritual content that they can utilise to strengthen their practices.
Source:
Kaasalainen, S., Sussman, T., McCleary, L., Thompson, G., Hunter, P. V., Wickson-Griffiths, A., ... & Parker, D. (2019). Palliative care models in long-term care: a scoping review. Can J Nurs Leadersh, Accepted for publication
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11. Discuss own role and responsibilities as an enrolled nurse in palliative care provision.

The role of nurses in palliative care is closely aligned with the overall care options that they give to the patient (Ding, Cook, Qin, Ho & Johnson, 2020). In fact, they have to work with their full capacity because they have to manage two ends of care at the same time; not only they are fully engaged with the patient but also they have to support the family members about keeping the level of loss and grief under control
Source:
Ding, J., Cook, A., Qin, X., Ho, S. C., & Johnson, C. E. (2020). Palliative care needs and utilisation of specialist services for people imminently dying with dementia: A national population-based study. International journal of nursing studies, 109, 103655
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