PALLIATIVE CARE OUTCOMES COLLABORATION PCOC Ongoing Education - PowerPoint PPT Presentation

Loading...

PPT – PALLIATIVE CARE OUTCOMES COLLABORATION PCOC Ongoing Education PowerPoint presentation | free to view - id: 13126d-MzBhZ



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

PALLIATIVE CARE OUTCOMES COLLABORATION PCOC Ongoing Education

Description:

PCOC is a national approach towards the routine assessment of palliative care ... and/or colostomy/bedpan/commode chair and/or insertion of enema/ suppository. ... – PowerPoint PPT presentation

Number of Views:64
Avg rating:3.0/5.0
Slides: 51
Provided by: haant
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: PALLIATIVE CARE OUTCOMES COLLABORATION PCOC Ongoing Education


1
PALLIATIVE CARE OUTCOMES COLLABORATION
(PCOC) Ongoing Education
Funded by the Australian Government
2
What is PCOC?
  • PCOC is a national approach towards the routine
    assessment of palliative care outcomes to assist
    palliative care service providers to deliver
    quality patient care

3
PCOC is
  • Continuous quality development of palliative care
  • Demonstrating outcomes (service and
    patient/caregiver)
  • Using standardised palliative care assessments
  • Using a common language
  • Providing a benchmarking process

4
What Happens to the data?
  • In this service…..
  • Uploaded into PCOC national database
  • 6mthly report compares your service against all
    other PCOC services

5
PCOC Information levels
  • Level 1 Patient- demographic
  • Level 2 Episode- setting of care
  • Level 3 Phase- clinical

6
(No Transcript)
7
(No Transcript)
8
Level 1 - Patient Information
  • Patient identifier
  • Date of birth
  • Sex
  • State identifier
  • Postcode
  • Indigenous status
  • Main language spoken at home
  • Country of birth

9
Level 1 Patient Information
  • Collect at episode start only
  • This information is collected by ………. in our
    service on ……. form

10
Level 2 - Episode Information
  • Episode tells us about the setting and how they
    enter and exit this setting
  • Episode A period of contact between a palliative
    care patient and a palliative care service that
    is provided by one palliative care service and
    that occurs in one setting (either admitted
    patient care or ambulatory patient care)

11
Level 2 - Episode Information
  • Service Responsiveness
  • Where the patient was referred from
  • Length of episode
  • How the episode ended
  • Diagnosis

12
Level 2 Episode Information
  • Collect at episode start
  • Collect at episode end
  • Procedure for collecting information in our
    service
  • This information collected by ………. in our service

13
Level 3 - Phase Information
  • Condition of patient acuity, progression of
    phases
  • Functional Status
  • Performance Status
  • Symptom Control
  • Problem Severity Distress
  • Length of Phase

14
Assessment tools
  • Phase
  • RUG - ADL Resource Utilisation Groups
    Activities Daily Living
  • Australian Karnofsky Performance Measure
  • Palliative Care Problem Severity Scale
  • Symptom Assessment Scale

15
Phase Assessment
  • Stable
  • Unstable
  • Deteriorating
  • Terminal
  • Bereaved

16
Phase Assessment
  • The palliative care phase is the stage of a
    persons illness
  • An assessment is holistic and views the patient
    and family as one unit
  • Palliative care phases are not sequential. A
    patient/family may move back and forth between
    phases

17
Stable Phase 1
  • The patients symptoms are adequately controlled
    by established management. Further interventions
    to maintain symptom control and quality of life
    have been planned
  • The situation of the family/carers is relatively
    stable and no new issues are apparent. Any needs
    are met by the established plan of care

18
Unstable Phase 2
  • The patient experiences the development of a new
    unexpected problem or a rapid increase or
    decrease in the severity of existing problems,
    either of which require an urgent change in the
    management or emergency treatment
  • The family/carers experience a sudden change in
    their situation requiring urgent intervention by
    members of the multidisciplinary team

19
Deteriorating Phase 3
  • The patient experiences a gradual worsening of
    existing symptoms or the development of new but
    expected problems. These require the application
    of specific plans of care and regular review but
    not urgent or emergency treatment.
  • The family/carers experience gradually worsening
    distress and other difficulties, including social
    and practical difficulties, as a result of the
    illness of the person. This requires a planned
    support program and counselling as necessary.

20
Terminal Phase 4
  • Death is likely in a matter of days and no acute
    intervention is planned or required
  • The family/carers recognise that death is
    imminent and care is focussed on emotional and
    spiritual issues as a prelude to bereavement
  • Some signs of this phase may include
  • Profoundly weak
  • Essentially bed bound
  • Drowsy for extended periods
  • Disoriented for time and has a severely limited
    attention span
  • Increasingly disinterested in food and drink
  • Finding it difficult to swallow medication

21
Bereaved Phase 5
  • Patient has died and bereavement support is
    offered
  • A planned bereavement support program is
    available including referral for counselling as
    necessary
  • Record only one bereavement phase per patient
    not one for each family/carer member

22
Phase
  • At episode start
  • At phase change or discharge / case closure
  • In this service -

23
RUG- ADL
  • The RUG-ADL is a 4 item scale measuring motor
    function with activities of daily living
  • Bed mobility
  • Toileting
  • Transfer
  • Eating
  • RUG-ADL tells us about the patient's functional
    status and the assistance they require for their
    activities of daily living

24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
RUG-ADL
  • Determine the score for each of the 4 domains,
    and total the score
  • Minimum score is 4 - maximum is 18
  • Total score 4 person is independent
  • Total score 18 person requires total assistance
    of 2 persons
  • Record what the person actually does, not what
    he/she is capable of

29
RUG-ADL
  • At episode start
  • At phase change or discharge / case closure
  • In this service -

30
Australian Karnofsky Performance Scale
  • Assesses performance status
  • Assesses 3 dimensions of health status
  • Activity
  • Work
  • Self care

31
Australian Karnofsky Performance Scale
32
Australian Karnofsky Performance Scale
  • At episode start
  • At phase change or discharge / case closure
  • In this service -

33
Problem Severity Score
  • A score for the overall degree of distress
  • Includes a specific rating for the family
  • Is assessed by the clinician

34
Problem Severity Score
  • Measure includes four domains
  • pain
  • other symptoms
  • psychological/spiritual
  • family/carer
  • The descriptors for PSS are

35
Problem Severity Score
  • Pain
  • The degree of overall pain

36
Problem Severity Score
  • Other Symptoms
  • Record the degree of distress
  • The following list may be used as a guide
  • Nausea/vomiting Confusion/delirium
  • Anorexia Dyspnoea
  • Itch/irritation Oedema
  • Constipation/diahorrea Incontinence
  • Wound/ulcer Weakness/fatigue

37
Problem Severity Score
  • Psychological / Spiritual
  • Record the score for overall degree of
    psychological/spiritual problems of the patient
  • The following list may be used as a guide
  • Anxiety/fear Request to die
  • Anger Agitation
  • Depression/sadness Confusion
  • Unrealistic goals

38
Problem Severity Score
  • Family / Carer
  • Record score for the overall degree of family /
    carer problems 0-3
  • The following list may be used as a guide
  • Cultural Family/carer accommodation
  • Anger Sensory impairment
  • Financial Unrealistic goals
  • Denial Caregiver fatigue
  • Non-English speaking Legal
  • Difficult communication
  • Family/carer conflict

39
Problem Severity Score
  • At episode start
  • At phase change or discharge / case closure
  • In this service -

40
Symptom Assessment Scale
  • Assesses symptoms from the patients perspective
  • Identifies the patients priorities in terms of
    distress
  • Allows you to track individual symptoms over time
    for each patient
  • Helps staff to identify the effectiveness of
    clinical interventions
  • Changes in symptoms, improvements or
    deterioration, can be measured

41
Symptom Assessment Scale
  • Seven key symptoms
  • 1. insomnia
  • 2. appetite problems
  • 3. nausea
  • 4. bowels
  • 5. breathing
  • 6. fatigue
  • 7. pain
  • Ratings are recorded to demonstrate the patients
    progress and changes in condition
  • Other symptoms can be added

42
Symptom Assessment Scale
  • This assessment requires effective communication
    skills
  • It involves incorporating a rating of a symptom
    into conversations with the patient

43
Symptom Assessment Scale
  • At episode start
  • At phase change or discharge / case closure
  • In this service -

44
Case Study
  • Refer to your handouts for case study details
  • In groups undertake assessments
  • Discuss results

45
Outcomes
  • Data to evaluate palliative care
  • Use of common assessment tools
  • Better understanding about what palliative care
    does

46
Outcomes
47
Outcomes
48
Outcomes
49
Outcomes
50
Discussion
About PowerShow.com