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What role do nurses play in caring for Elicit goals of care
seriously ill patients and their families? Assess, manage, coordinate care
Listen
Bear witness
Communicate with team
Knowledgeable in evidence based practice
What are the top five leading causes of Heart disease
death in america? Cancer
Chronic lower respiratory disease
Unintentional injury
Cerebrovascular diseases
What is the impact of serious illness in Exploding healthcare costs
America on care? Poor understanding of prognosis
Failure to treat pain and other symptoms
Increased use of technology
What constitutes quality of life care at end Providing symptom management and discussing the
of life for the health care team? emotional aspects of the disease
What constitutes quality care at the end of achieving a sense of control, attaining spiritual peace,
life for patients succeeding in having finance in order, strengthening
relationships with loved ones, and believing that their life has
meaning `
T/F most adults prefer to die at home? True
Nearly 40% of enrolled veterans live in Rural
_____________ communities
T/F the majority of veterans die in VA False
facilities
What is palliative care? Patient and family centered care that optimizes quality of life
by anticipating, preventing, and treating suffering
, What are the characteristics of palliative Interdisciplinary care
care philosophy and delivery? Excellent communication between patients, families, and
health care providers
Services provided concurrently with or independent of
curative/life prolonging care
What are the barriers to quality care at the Failure to acknowledge the limits of medicine
end of life? Workforce too small to meet demands
Lack of training
Hospice/palliative care poorly understood
Lack of payment models linked to quality measures
Rules and regulations
Denial of death
What are the two parts of prognostication? Foreseeing (estimating prognosis)
Foretelling (discussing prognosis)
What parts of performance status did ECOG poor predictors, multiple symptoms, biological markers
karnofsky look at?
What type of patients did the pivotal study Patients with metastatic non small cell lung cancer
for palliative care involve?
In the pivotal study for palliative care Increased quality of life and mood
involving Patients with metastatic non small Less aggressive care
cell lung cancer what was found in those Longer survival``
who received early palliative care received
what benefits?
Does Palliative Care Improve Care, Yes, improved home care leads to increased satisfaction,
Decrease Hospitalizations & Save Money fewer admissions, shorter stays, and savings of more than 700
per patient per month
What is the role of the nurse in palliative Some things cannot be fixed
care? Use of therapeutic presence
Maintaining a realistic perspective
T/F patients who recieve an earlier palliative True:
care consult save the hospital money?
What should be assessed when utilizing Physical symptoms
palliative care? Emotional symptoms
Spirituality
Quality of life
Caregivers outcomes
What is the FICA tool used for? Taking a spiritual history
What does FICA stand for? F: faith and belief
I: importance
C: community
A: address in care
The _______________________________ act was the first Patient self-determination act
federal law to focus on rights of adults to
refuse treatment
T/F once signed advance directives are True
legally enforceable?