跨專業團隊合作新模式

May 27th, 2016 in Reflection

Author: Choy Yin Ping, NC (ONC), KWC

Affiliations: Nurse Consultant., Princess Margaret Hospital, Hong Kong

去年,我有幸代表我的團隊到首爾參加第二屆亞洲腫瘤科護理會議(AONS 2015 Conference),發表了有關跨專業團隊合作診治新服務模式的學術報告。很高興這份報告被大會評審為大會最佳報告之一。

所謂跨專業團隊合作診治新服務模式,是病人接受抗癌治療期間,除了醫生的診症外,我們會定期加入腫瘤科護士和其他專業團隊(如臨床藥劑師)的診症服務。這種服務模式最大的優點是各專業團隊可以發揮其專業所長,相互協作,為病人和家屬提供更有效率和更全面的服務。

腫瘤科護士可透過對病人的診症、評估、教育與輔導,發揮全人護理中「身、心、社、靈」的理念,提升了腫瘤科護士在癌症治療中的重要角色。這種嶄新的護理模式深得病人和其家屬的肯定,在每一次的病人滿意程度調查中,我們的護理診症服務都被給予很高的評價,實在令人鼓舞。

隨著癌症治療科學日新月異的發展,各種癌症的治愈機會愈來愈高,病人的壽命亦得以大大延長。病人和其家屬在治癌以至復康的漫長過程中所需的支援便愈來愈多。身為腫瘤科護士的我們肩負的任務將會愈加重大,但我深信這是我們專業發展中必須前進的路向,而這種跨專業團隊服務的模式相信亦是醫療發展的方向之一。

 

Choy Yin Ping

New Resources to Advance Palliative Care

May 12th, 2016 in Hot Topics

Authors: Jeanne M. Erickson, RN, PhD, AOCN

Affiliations: Assistant Professor, University of Wisconsin-Milwaukee College of Nursing

Oncology nurses continue to make progress to improve care for patients with advanced cancer at the end of life. An important group behind this progress is the American Association of Colleges of Nursing (AACN), who in 1997 developed recommendations for educating undergraduate nursing students about end-of-life care in Peaceful Death:  Recommended Competencies and Curricular Guidelines for End-of-life Nursing Care.1  AACN also developed the End-of-Life Nursing Education Consortium (ELNEC), a project to train health care providers and improve end-of-life care for patients in their communities. To date, the ELNEC project has reached over 550,000 health care providers in 88 countries.2

Today, nearly 20 years later, the emphasis is moving to educate nursing students and nurses about palliative care and to distinguish palliative care from end-of-life care.  Palliative care is defined as the management of symptoms and side effects in patients who have been diagnosed with a serious or life-threatening disease or condition, such as cancer.  A palliative care approach emphasizes that symptom relief needs to begin at the time of diagnosis and continue throughout the course of the disease.  Palliative care prioritizes the patient’s comfort and quality of life and should not be emphasized only at the end of life when cure or control of disease is no longer possible.

The AACN has again taken a lead in this educational endeavor and has developed recommendations to educate nursing students about palliative care concepts.  These recommendations for palliative care competencies, Competencies and Recommendations for Educating Undergraduate Nursing Students:  Preparing Nurses to Care for the Seriously Ill and Their Families, are built on the original work of the AACN related to end-of-life care and emerged from a roundtable of palliative care experts held in the fall of 2015.3  This latest AACN document suggests content and possible placement for the content in undergraduate nursing courses.  AACN also plans to make a series of modules with condensed ELNEC content available for nurse educators in 2017 to promote integration of palliative care content into schools of nursing.

The International Society of Nurses of Nurses in Cancer Care (ISNCC) also recognizes and supports the central role of oncology nurses in the delivery of palliative care.  In October 2015, ISNCC approved a Palliative Care Position Statement that recommends palliative care as an educational priority for health care providers, especially for the global workforce of nurses.4   This Statement also acknowledges the special needs of local and global communities with inadequate resources, where patients may suffer due to a lack of medications and other interventions to relieve distressing symptoms.

It is now up to us as oncology nurses and nurse educators to advance the competencies of current and future nurses to deliver palliative care to all patients throughout their course of cancer treatment, especially those patients who are vulnerable due to a lack of resources.   We can promote these recommendations for palliative care education by sharing them with our colleagues at affiliated schools of nursing.  As educators, we can work to incorporate this content as we teach in clinical and classroom settings and mentor nurses to become leaders in the field of palliative care.  As clinicians and administrators, we can ensure that we follow current, evidence-based palliative care interventions that prioritize the comfort of our patients and their families. As researchers, we can work to improve the science of symptom management to address the complex symptoms of our patients. As a global nursing workforce, we can promote the delivery of palliative care through our practice, education, research, and service.

 

References

  1. American Association of College of Nursing. Peaceful Death:  Recommended Competencies and Curricular Guidelines for End-of-life Nursing Care.  (1997).  Accessed March 26, 2016 at http://www.aacn.nche.edu/elnec/publications/peaceful-death
  2. American Association of College of Nursing. ELNEC Fact Sheet.  Accessed March 26, 2016 at http://www.aacn.nche.edu/elnec/about/fact-sheet
  3. American Association of College of Nursing. CARES:  Competencies And Recommendations for Educating Undergraduate Nursing Students.   Accessed March 26, 2016 at http://www.aacn.nche.edu/elnec/New-Palliative-Care-Competencies.pdf
  4. International Society of Nurses in Cancer Care. ISNCC Palliative Care Position Statement.  Accessed April 2, 2016 at http://c.ymcdn.com/sites/www.isncc.org/resource/resmgr/Position_Statements/ISNCC_Palliative_Care_Positi.pdf
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