Week 3 - Prerequisite knowledge Flashcards by Mia Philip

What is the definition of Palliative care according to WHO?

Improves quality of life for people with life-threatening illness and their families through early identification, impeccable assessment, and treatment of pain and other problems (physical, psychosocial, spiritual)

Focuses on enhancing the quality of life rather than curing the illness.

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What is the difference between a palliative approach and specialist palliative care?

Palliative approach: Philosophy and care models applied across settings
Specialist palliative care: Provides consultancy, in-patient units, community services, NP roles

The palliative approach can be integrated into various healthcare settings.

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Define End-of-life (EOL) care.

Care in the last months–days to reduce distress for the person and family; guided by national consensus statements and standards

Aims to provide comfort and support during the final stages of life.

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Where does palliative care occur? List the settings.

Community: People’s homes, RACFs, accommodation for mental illness, correctional facilities, general practice, community palliative care clinics/day centres
Hospital: Inpatient palliative beds, other inpatient beds (acute/sub-acute/other), outpatients, ICU, ED
Around the person: Consultancy linking community and hospital

Palliative care can be provided in various environments to meet patient needs.

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What are the National Palliative Care Standards (NPCS)?

Standards 1–6: Assessment of needs, Developing the care plan, Caring for carers, Providing care, Transitions, Grief support
Standards 7–9: Service culture, Quality improvement, Staff qualifications & training

These standards are essential for ensuring quality palliative care.

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What quality tools/resources are associated with palliative care?

PaCSA self-assessment
COSA chart
Last Days of Life toolkits
Care plan for the dying person (Vic)
Victorian Palliative Care Advice Service
Anticipatory Medicines (Vic)

These resources help in the assessment and planning of palliative care.

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What does the mnemonic OPQRSTU stand for in symptom history assessment?

Onset
Provokes/Palliates
Quality
Region/Radiation
Severity
Time
You—meaning/impact

This mnemonic aids in thorough symptom assessment.

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What does the mnemonic PEPSCC represent in holistic domains?

Physical
Emotional/psych
Practical/social
Spiritual
Cultural
Carer

This framework ensures comprehensive care addressing various aspects of a patient’s well-being.

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Dyspnoea management includes which interventions?

Fan/cool air
Upright position
Pace
Consider low-dose opioid
Oxygen only with clear benefit
Reassess distress score

These interventions aim to alleviate breathing difficulties effectively.

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For noisy secretions, what are the recommended actions?

Reposition head-up/side
Explain the situation
Avoid suction
Anticholinergics have limited benefit

These measures help manage secretions without causing further discomfort.

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What should be checked when managing nausea?

Check bowels/meds
Pathway-matched antiemetic
Small frequent intake
Pre-meal dosing

These steps are crucial for effective nausea management.

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In cases of delirium, what are the first steps to take?

Identify reversibles
Calm environment/safety
Consider haloperidol/atypical
Benzodiazepine for hyperactive if needed

Addressing underlying causes is essential in managing delirium.

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What interventions are suggested for constipation?

Fluids/mobility
Routine laxative with opioids
Monitor

These measures help alleviate constipation effectively.

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How can xerostomia/oral care be managed?

Frequent sips/saliva substitutes
Mouth care protocol
Lip balm

These strategies help maintain oral comfort.

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What is recommended for managing fatigue?

Energy conservation + gentle activity
Stimulant only case-by-case

These approaches help balance activity and rest.

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What measures can be taken for pruritus?

Skin measures
Antihistamine trial

These interventions aim to relieve itching effectively.

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What should be focused on regarding end-stage hydration?

Comfort-focused mouth care/ice
Avoid burdensome fluids

The goal is to ensure comfort without unnecessary interventions.

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List the red-flag symptoms that require escalation.

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New severe dyspnoea at rest
Haematemesis/melaena
Sudden agitation with risk
Uncontrolled vomiting
Bowel obstruction signs
New neuro deficits
Uncontrolled pain despite two PRNs

These symptoms indicate urgent medical attention is needed.

Define palliative care (WHO) in one line

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An approach that improves quality of life of people with life-threatening illness and families via early identification, impeccable assessment, and treatment of physical, psychosocial, and spiritual problems.

Differentiate palliative approach vs specialist palliative care

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Palliative approach = philosophy and generalist practices across settings; Specialist PC = dedicated teams/services (consultancy, inpatient units, community SPC, NP roles) for complex needs.

Define end-of-life (EOL) care

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Care in the last months–days aimed at reducing distress for the person and family, guided by national consensus statements and standards.

List three community settings where palliative care occurs

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Homes
Residential Aged Care Facilities
GP/community clinics (including mental health accommodation and correctional facilities).

List three hospital settings where palliative care occurs

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Inpatient palliative beds
Other acute/sub-acute wards
ICU/ED/outpatients.

What does “around the person” consultancy mean?

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Specialist palliative clinicians provide liaison across community and hospital to align goals and care wherever the person is.

NPCS Standards 1–6 (name the **focus**)

* 1 Needs assessment * 2 Care planning * 3 Caring for carers * 4 Providing care * 5 Transitions * 6 Grief support.

NPCS Standards 7–9 (name the **focus**)

* 7 Service culture * 8 Quality improvement * 9 Staff qualifications and training.

Why are NPCS mapped to **NSQHS and Aged Care standards**?

To align palliative care with national safety/quality frameworks and accreditation requirements across settings.

What is **PaCSA** and why use it?

Palliative Care Self-Assessment: nine checklists for services to self-assess against the National Palliative Care Standards and drive QI.

What is a **COSA chart** used for?

Comfort Observation & Symptom Assessment: colour-coded observation tool linking EOL symptoms to specific comfort actions.

Purpose of **Last Days of Life toolkits**

Support generalist clinicians to recognise dying, guide symptom management, prompt key questions, and standardise care in the final days/hours.

**Victorian Palliative Care Advice Service**—who and when?

For all Victorians/clinicians needing non-emergency advice about life-limiting illness, palliative or EOL care—used for guidance outside emergencies.

**Anticipatory Medicines (Victoria)**—core aim

Pre-prescribed SC/sublingual meds at home/RACF to enable rapid symptom relief and avoid unwanted/unplanned hospital admissions.

**Care plan for the dying person (Vic)**—what it covers

Recognising dying; reviewing meds/interventions; planning and delivering individualised care; documenting preferences; care after death.

**OPQRSTU**—expand the mnemonic

* Onset * Provokes/Palliates * Quality * Region/Radiation * Severity * Time * You—meaning/impact.

**PEPSCC**—expand the holistic domains

* Physical * Emotional/psychological * Practical/social * Spiritual * Cultural * Carer needs.

Minimum dataset for each **reassessment (3–5 items)**

* Symptom scores/COSA triggers * Intake/bowels * Cognition/delirium screen * Interventions given (dose/route/time) and effect * Family concerns/goals update.

One sentence goal of the **palliative approach**

Maximise quality of living for the person and family through proactive, holistic symptom relief and support.

Key difference between **palliative and EOL care timing**

Palliative can start at diagnosis of life-limiting illness; EOL focuses on the last months–days when dying is expected.

Example of **generalist vs specialist task**

Generalist: routine symptom review + care plan updates; Specialist: complex refractory symptoms, advanced prescribing, service education.

Two reasons to **integrate palliative care early**

* Improves symptom control and decision-making * Supports carers and reduces burdensome, non-beneficial interventions.

One practical way to **tailor information to health literacy**

Use teach-back: ask the person/family to explain in their own words what to do if a red flag occurs.

Two quick **family-support actions at EOL**

* Prepare expectations (e.g., decreased intake, breathing changes) * Provide specific comfort strategies (mouth care, positioning, quiet environment).

Which standard covers **bereavement** and why note it early?

NPCS Standard 6 (Grief support); early risk screening and information improve post-death support for families.

Week 3 - Prerequisite knowledge Flashcards

(43 cards)