Management of signs and symptoms in cardiac patients with need for palliative care using auxiliary tools and guidelines

    Authors

    Keywords

    palliative medicine, terminal phase, guidelines, clinical indicators

    DOI

    https://doi.org/10.15836/ccar2016.573

    Full Text

    Today, palliative medicine (palliative care), is not just directed to tumor diseases, but also to others, such as chronic, progressive lung disease, kidney disease, chronic heart failure (1), HIV / AIDS and progressive neurological conditions. The goal of palliative care is to improve quality of patient’s life, as well as the quality of their family life. It is aimed at solving the most sensitive period of human life in which human rights are most at risk. The area in the terminal phase of life is a challenge of nursing ethics on whether the basis of ethics stands in the idea of care or the idea of science? Efforts to avoid unwanted events in the later stage of the disease can be achieved with proper timely identification of patient’s need for palliative care. European GSF-PIG guidelines are recommended as a basic tool with prognostic indicators to identify patients who are approaching the end of life and are in need for palliative care. SPICT is used as an auxiliary tool for quickly grading, CRISTAL as an auxiliary tool for fast recognition in the emergency department while QUICK GUIDE is a tool for keeping a register of patients in palliative care. Guide to identify the person (SPICT) with an increased risk of deterioration and death with two or more indicators of deteriorating health, also defines clinical indicators. For cardiovascular disease clinical indicators are NYHA III/IV category of heart failure, an incurable disease of the coronary arteries, dyspnea, severe inoperable peripheral vascular disease. This approach provides an objective assessment and definition of a dying patient. It allows honest communication with the patient and family, and a management plan for associated signs and symptoms. Medical documentation (E-card) and Nursing letter of discharge enable good coordination with the Team of palliative care in primary health care.

    Literature

    1. Mentz RJ, Tulsky JA, Granger BB, Anstrom KJ, Adams PA, Dodson GC, et al. The palliative care in heart failure trial: rationale and design. Am Heart J. 2014 Nov;168(5):645–651.e1. https://doi.org/10.1016/j.ahj.2014.07.018
    Cardiologia Croatica
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    Management of signs and symptoms in cardiac patients with need for palliative care using auxiliary tools and guidelines

    Extended Abstract
    Issue10-11
    Published
    Pages573
    PDF via DOIhttps://doi.org/10.15836/ccar2016.573
    palliative medicine
    terminal phase
    guidelines
    clinical indicators

    Authors

    Ruža Evačić*ORCIDGeneral Hospital „Dr. T. Bardek“, Koprivnica, Croatia

    Full Text

    Today, palliative medicine (palliative care), is not just directed to tumor diseases, but also to others, such as chronic, progressive lung disease, kidney disease, chronic heart failure (1), HIV / AIDS and progressive neurological conditions. The goal of palliative care is to improve quality of patient’s life, as well as the quality of their family life. It is aimed at solving the most sensitive period of human life in which human rights are most at risk. The area in the terminal phase of life is a challenge of nursing ethics on whether the basis of ethics stands in the idea of care or the idea of science? Efforts to avoid unwanted events in the later stage of the disease can be achieved with proper timely identification of patient’s need for palliative care. European GSF-PIG guidelines are recommended as a basic tool with prognostic indicators to identify patients who are approaching the end of life and are in need for palliative care. SPICT is used as an auxiliary tool for quickly grading, CRISTAL as an auxiliary tool for fast recognition in the emergency department while QUICK GUIDE is a tool for keeping a register of patients in palliative care. Guide to identify the person (SPICT) with an increased risk of deterioration and death with two or more indicators of deteriorating health, also defines clinical indicators. For cardiovascular disease clinical indicators are NYHA III/IV category of heart failure, an incurable disease of the coronary arteries, dyspnea, severe inoperable peripheral vascular disease.

    This approach provides an objective assessment and definition of a dying patient. It allows honest communication with the patient and family, and a management plan for associated signs and symptoms. Medical documentation (E-card) and Nursing letter of discharge enable good coordination with the Team of palliative care in primary health care.

    Literature

    1. 1.
      Mentz RJ, Tulsky JA, Granger BB, Anstrom KJ, Adams PA, Dodson GC, et al. The palliative care in heart failure trial: rationale and design. Am Heart J. 2014 Nov;168(5):645–651.e1.DOI