Integrated, collaborative palliative care in heart failure: the St. George Heart Failure Service experience 1999-2002
| Autor: | Jill Cockburn, Jan Maree Davis, Linda Magann, Kathleen Dracup, David J Gorman, Kate Introna, Mary Lafferty, Patricia M. Davidson, David Rees, Glenn Paull |
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| Rok vydání: | 2004 |
| Předmět: |
Program evaluation
medicine.medical_specialty Palliative care Collaborative Care Professional Role Nursing Health care Medicine Humans Community Health Services Disease management (health) Cooperative Behavior Program Development Hospitals Teaching Curative care Advanced and Specialized Nursing Heart Failure Patient Care Team business.industry Delivery of Health Care Integrated Palliative Care Health services research Disease Management Continuity of Patient Care Hospital Bed Capacity 500 and over Interinstitutional Relations Family medicine Models Organizational Needs assessment Health Services Research New South Wales Cardiology and Cardiovascular Medicine business Nurse Clinicians Needs Assessment Program Evaluation Total Quality Management |
| Zdroj: | The Journal of cardiovascular nursing. 19(1) |
| ISSN: | 0889-4655 |
| Popis: | Background Chronic heart failure (HF) is the only heart condition increasing in prevalence and is primarily a condition of aging. This condition has outcomes worse than many cancers; however, patients are often denied the benefits of palliative care with its important emphasis on symptom management, spirituality, and emotional health and focus on family issues. Aim To describe the development of a model of an integrated, consultative, palliative care approach within a comprehensive HF community-focussed disease management program. Method A collaborative model was developed following a systematic needs assessment and documentation of local resources. Principles underpinning this model were based upon fostering of communication, consultancy, and skill development. Within this model a health care system, based upon universal coverage, supported co-management of patients and their families. The place of death, level of social support available at home, and degree of palliative care involvement was documented in 121 consecutive deaths from 1999-2002. Findings Following a period of skill sharing and program development, only 8.3% of HF patients in the collaborative program required specialized palliative care intervention for complex symptom management, carer support, and issues related to spirituality. Twenty percent of this cohort died in nursing homes underscoring the importance of supporting our nursing colleagues in this setting. Conclusions In spite of well-documented difficulties in determining prognosis, it is the St George experience that key principles of a palliative care strategy can be implemented in a HF disease management program with support and consultancy from expert palliative care services. |
| Databáze: | OpenAIRE |
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