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El. knyga: Care of the Dying: A Pathway to Excellence 2nd Revised edition [Oxford Scholarship Online E-books]

Edited by (Head of Palliative Care Research, Marie Curie Palliative Care Research & Development Unit, Royal Free), Edited by (Professor of Palliative Medicine, University of Liverpool and Director of the Marie Curie Palliative Care Institute, Liverpool, UK)
  • Formatas: 284 pages, 30 black and white line drawings and 5 black and white halftones
  • Išleidimo metai: 02-Dec-2010
  • Leidėjas: Oxford University Press
  • ISBN-13: 9780199550838
Kitos knygos pagal šią temą:
  • Oxford Scholarship Online E-books
  • Kaina nežinoma
  • Formatas: 284 pages, 30 black and white line drawings and 5 black and white halftones
  • Išleidimo metai: 02-Dec-2010
  • Leidėjas: Oxford University Press
  • ISBN-13: 9780199550838
Kitos knygos pagal šią temą:
Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This unique book provides guidelines for the care of the dying based on the Liverpool Integrated Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes.The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template which describes the process of care which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education and quality improvement programmes. This book also includes chapters on symptom control, ethical issues, communication skills, and spiritual care written by experts in the field which underpin the use of the LCP.Care of the Dying Second Edition will prove invaluable to all healthcare professionals involved in the care of the dying patient, organisations and Trusts who want to develop demonstrable measures and outcomes of care.
Foreword xi
Cicely Saunders
Contributors xv
Introduction xix
John Ellershaw
1 What about care pathways?
1(14)
Kris Vanhaecht
Massimiliano Panella
Ruben van Zelm
Walter Sermeus
Introduction
1(1)
The pathway history and definition
2(1)
Pathways as concept, model, process, and product
3(8)
Discussion and challenges for palliative care
11(4)
2 What is the Liverpool Care Pathway for the Dying Patient (LCP)?
15(18)
John Ellershaw
Deborah Murphy
Introduction
15(1)
The LCP Continuous Quality Improvement Programme
15(1)
Care in the last hours or days of life
16(1)
Format and outline of the LCP
17(1)
What is variance reporting?
17(1)
Innovation and change model
18(1)
What is organizational governance?
18(1)
LCP generic version 12 document
19(1)
Diagnosing dying: the decision to commence the LCP to support care in the last hours or days of life
20(2)
How should the LCP be completed?
22(8)
Conclusion
30(3)
3 Symptom control in care of the dying
33(30)
Paul Glare
Andrew Dickman
Margaret Goodman
How can the Liverpool Care Pathway influence symptom control?
33(3)
How do you manage pain in the dying patient?
36(4)
How do you manage agitation in the dying patient?
40(3)
How do you manage nausea and vomiting in the dying patient?
43(1)
How do you manage respiratory tract secretions in the dying patient?
44(1)
How do you manage dyspnoea in the dying patient?
45(2)
What are the benefits of using a continuous subcutaneous infusion (CSCI) to deliver medication?
47(4)
Comfort measures in the last hours or days of life
51(1)
Mouth care
52(1)
Micturition difficulties
53(2)
Bowel care
55(1)
Management of skin
56(7)
4 Ethical issues in care of the dying
63(22)
Andrew Thorns
Eve Garrard
What is the moral justification for the Liverpool Care Pathway?
63(1)
How can the Liverpool Care Pathway for the Dying Patient influence ethical decision making?
63(1)
An ethical framework
64(2)
Withholding and withdrawing interventions and treatments at the end of life
66(2)
If there is a decision between a treatment that will prolong life and one that will only promote comfort, should the right action always be one that extends life?
68(1)
Cardiopulmonary resuscitation (CPR)
69(2)
Issues of hydration and nutrition
71(2)
Issues of ventilation
73(1)
Shortening and ending life: the doctrine of double effect and assisted dying
74(3)
Issues relating to capacity and decision making
77(8)
5 Communication in care of the dying
85(22)
Susie Wilkinson
What are the skills that facilitate communication?
87(1)
Blocking tactics that can hinder communication
87(4)
Are the patient and their family aware of the patient's deteriorating condition?
91(1)
The patient assessment
91(3)
Handling difficult questions
94(2)
Dealing with uncertainty
96(1)
Breaking bad news of a deteriorating condition
96(2)
Communicating with relatives
98(1)
Handling feelings and emotions
99(1)
Communicating with families who want to protect patients from the truth
100(2)
Cultural issues in communication
102(1)
The challenge of working with colleagues
103(4)
6 Spiritual/religious issues in care of the dying
107(22)
Peter Speck
How can the Liverpool Care Pathway for the Dying Patient (LCP) influence religious and/or spiritual care?
107(1)
Is there a research base for spiritual care in palliative care?
107(2)
What is spiritual care?
109(1)
What is religious care?
109(1)
What about people who claim to be neither religious nor spiritual?
110(1)
When should we make the assessment?
111(1)
How can we assess this aspect of people's lives?
111(2)
What about the needs of different religious/faith groups
113(11)
What of the non-religious spiritual needs?
124(1)
Who should meet the needs assessed?
125(1)
Acknowledgement
126(3)
7 Supporting family and friends as death approaches and afterwards
129(16)
Carole Mula
Bereavement
129(2)
Anticipatory grief
131(1)
Current risk management strategies
132(3)
Key considerations alongside risk factors
135(1)
What is involved in making an assessment?
135(1)
Preparing the family for the imminent death
136(1)
Last offices
137(1)
Organ/tissue donation
137(1)
Medical and legal issues
138(1)
Saying goodbye and viewing the deceased
139(1)
Information needs
140(5)
8 Supporting children---as death approaches and afterwards
145(12)
Barbara Monroe
The impact of bereavement upon children
145(2)
How do we help parents to help their children?
147(2)
Helping parents to talk to their children
149(1)
Giving information
150(1)
Being present and being involved
150(1)
When death is unexpected
150(1)
Viewing the body
151(1)
Attending funerals
151(1)
Children's understanding of death
152(1)
Subsequent support
152(1)
Children need support to remember
153(4)
9 Induction and implementation of the Liverpool Care Pathway for the Dying Patient
157(16)
Maureen Gambles
Anita Roberts
Rita Doyle
Introduction
157(1)
Implementing the LCP
158(1)
Phase 1 Induction
159(2)
Phase 2 Implementation
161(4)
Phase 3 Dissemination
165(5)
Phase 4 Sustainability
170(1)
Summary
170(3)
10 Dissemination and sustainability strategy for the LCP programme: incorporating a model for national audit for care of the dying
173(16)
Deborah Murphy
Tamsin McGlinchey
National clinical audit in context
175(1)
The impact of national clinical audit
175(2)
NCDAH: driving up quality in care of the dying as part of a Continuous Quality Improvement Programme
177(6)
Key performance indicators (KPIs)
183(3)
LCP version 12 consultation exercise
186(1)
Summary
186(3)
11 International development of the Liverpool Care Pathway for the Dying Patient (LCP)
189(18)
Ruthmarijke Smeding
Maria Bolger
John Ellershaw
LCP International: setting the scene
189(1)
LCP international activity
190(1)
Phase 1 Induction---establishing the project and preparing the environment for organizational change
191(6)
Phase 2 Implementation
197(1)
Phase 3 Dissemination
198(3)
Phase 4 Sustainability
201(2)
Development of a State/Country/National LCP Office
203(1)
Conclusion
203(4)
Appendix 1 The LCP core documentation and supporting information 207(22)
Appendix 2 Ongoing assessment of the plan of care (non inpatient setting) 229(2)
Appendix 3 Completed pathway 231(22)
Appendix 4 Coping with dying leaflet 253(2)
Index 255
John Ellershaw is professor of palliative medicine at the University of Liverpool and director of Marie Curie Palliative Care Institute. He is also national deputy clinical director for end of life care.