Der Zweck dieses Konsensus-Dokuments ist die Beantwortung der Frage: "Welche Kompetenzen sind in Bezug auf den klinischen Einsatz von Palliativversorgung für alle Fachkräfte wichtig, und zwar unabhängig von ihrer spezifischen Berufsgruppenzugehörigkeit?" Es ist allgemein anerkannt, dass die Palliativversorgung in einem breiten Spektrum von Bereichen der Gesundheitsversorgung durchführbar ist, vom Krankenhaus der Maximalversorgung bis hin zur medizinischen Grundversorgung. Alle in der Gesundheitsversorgung Beschäftigten sollten eine angemessene Palliativversorgung anbieten können. Sie müssen daher aus-und weitergebildet werden, den herausfordernden Bedürfnissen der Patienten und ihrer Familien gerecht zu werden, um den höchstmöglichen Versorgungsstandard zu erreichen, unabhängig von der zugrunde liegenden Diagnose. Das vorliegende EAPC-Weißbuch zeigt Expertenmeinungen zu globalen Kernkompetenzen für die professionelle Praxis unabhängig von Berufsgruppen auf und ist als eine Ressource für Praktiker und Lehrende gleichermaßen gedacht. Die hier beschriebenen 10 Kernkompetenzen könnten dabei helfen, Rollen und Verantwortlichkeiten von Teams zu entwickeln, die Palliativversorgung in ihren Gesundheitssystemen anbieten und weiterentwickeln möchten. Abstract !The purpose of this White Paper is to address the question: "What competencies for clinical practice in palliative care are important for all practitioners, irrespective of their specific discipline?". It is widely recognised that palliative care is applicable across a range of healthcare settings, from tertiary hospitals to primary care. All healthcare professionals and workers should be able to provide appropriate palliative care and thus need to be trained to provide the highest possible standards of care in order to meet the challenging needs of patients and families, irrespective of diagnosis. This EAPC White Paper presents expert opinion on global core competencies for professional practice, irrespective of discipline, and is intended as a resource for practitioners and educators alike. We propose that the ten core competencies identified in this White Paper may assist in scoping the roles and responsibilities of palliative care teams as they strive to provide care within different healthcare systems.
When caring for terminally ill patients and their families, nurses are confronted with the subject of terminal dehydration and the question of artificial hydration at the end of life. Terminal dehydration and artificial hydration are still controversial topics of discussion and, to this day, data remain insufficient to reach a final conclusion on the benefits or harm of dehydration in terminally ill patients (Ersek, 2003; Fainsinger, 2008). Nurses, just like physicians, have different attitudes about the usefulness of artificial hydration. Personal and professional experiences, cultural influences, and the place of care, as well as education and available resources, are guiding clinical practice (Morita et al, 2002; Pasman et al, 2004). Since there is no ethically or medically based gold standard, each decision for or against hydration at the end of life needs to be taken on an individual basis. This article reflects on the meaning of dehydration for the patient and their family, and reviews the role of the nurse within the decision-making process. Arguments for or against artificial hydration are illuminated through patient situations which took place in the clinical setting of a hospice. The article further highlights the importance of recognising dehydration in frail and elderly patients, and critically assesses policies that may hinder its optimal palliation in different settings in Switzerland.
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