Palliative Care Panel

Question 1

What is the role of clinical nurse specialist?

Answer 1

• Coordinate HPC services
• Works at regional and local level to ensure systems are in place that meets family and patient needs
• Provides consultation and support in all locations
• Education
• Special projects

Question 2

What is the role of the clinical resource nurse?

Answer 2

• Coordinate clinical aspect of care by meeting with patients and families to determine goals of care and assist with complex care needs
• Acts as resource for primary care givers
• Palliative response nurse for BC NurseLine after hours service
• Education

Question 3

What is the role of the physician?

Answer 3

• Provide medical support to care program through direct consultation and by acting in an advisory capacity
• Attend weekly rounds
• Participate in planning and educational activities

Question 4

What is the role of the pharmacist?

Answer 4

• Provide consultative service to staff, physicians, patients and families regarding med/symptom management
• Participate in planning and education

Question 5

What is the role of the social worker?

Answer 5

• Work with patients and families to provide support and assist in realizing goals
• Counseling, requesting community services, advocating and providing bereavement support
• Case conferences and complex d/c planning
• Staff support
• Participates in team activities (e.g. rounds, planning, education)

Question 6

What is the role of the dietician?

Answer 6

• Works with patients and families to assess and provide nutritional support PRN
• Participate in hospital rounds
• Consultative service available for patients at home

Question 7

What is the role of the home support supervisor?

Answer 7

• Works with patient and family to develop a care plan
• Supervises community health workers and ensure they are providing appropriate care
• Education

Question 8

What is the role of the hospice society program manager?

Answer 8

• Coordinates services provided by hospice society volunteers (one to one support, hospital teams, vigil services)
• Provides training and support for volunteers
• Participate in HPC activities such as rounds and planning

Question 9

What is the nursing role?

Answer 9

• Nurses in all locations to manage day-to-day care for patients and families
• Using a holistic approach provides care to ensure all needs are met

Question 10

What is the role of rehab services?

Answer 10

• Assess patients functional and mobility issues, safety concerns and equipment needs
• Do interventions and teaching PRN

Question 11

What is the role of the spiritual care coordinator?

Answer 11

• Provide spiritual support, counseling and bereavement follow-up PRN
• Staff support
• Participates in team activities such as rounds, planning and education

Question 12

What is the palliative performance scale?

Answer 12

• Based on ambulation; activity and evidence of disease; self-care ability; intake; and conscious level
• 100% = full ambulation; normal activity, no evidence of dx; full self care; normal intake; full LOC
• 50% = Mainly sit/lie ambulation; unable to do any work, extensive dx; considerable assistance required for self-care; normal or reduced intake; full or confusion LOC
• 10% = totally bed bound; unable to do any activity, extensive dx; total care; mouth care only intake; drowsy or coma, +/- confusion
• 0% is death
• Determined based off of best-fit after assessment

Question 13

Who is eligible for BC palliative care benefits?

Answer 13

• Two types of benefits includes PharmaCare BC Palliative care drug plan and local health authority, which includes assessment and coverage for certain medical supplies and equipment
• Drug plan covers 100% of prescription meds needed for palliative care, and certain OTC drugs necessary to support care
• Supplies and equipment may include med administration supplies (e.g. syringes); IV therapy supplies; wound care supplies; equipment like walkers, commodes, hospital beds, etc.
• Anyone who wants to receive palliative care at home can ask HCP about assessment for eligibility, and HCP submits forms

Question 14

What makes up the medical orders for scope of treatment form?

Answer 14

• Code status (either CPR or CNR)
• A MOST designation indicating decisions regarding scope of medical interventions
• M1, M2, M3 or C1, C2

Question 15

What is M1?

Answer 15

• Supportive care, symptom management and comfort measures
• Allow natural death
• Transfer to higher level of care only if comfort needs not met in current location

Question 16

What is M2?

Answer 16

• Med treatments available within location of care

- Transfer to higher level of care only if patient’s comfort needs not being met

Question 17

What is M3?

Answer 17

• Full medical treatments excluding critical care, OR:
• C1: critical care interventions excluding intubation
• C2: critical care interventions including intubation and resuscitation

Question 18

Define: Advance care planning

Answer 18

• Process of a capable adult talking over their beliefs, values and wishes about the health care they wish to consent to or to refuse, with their HCP or family, in advance of a situation when they are incapable of making health decisions
• A advance care plan is a written summary