One Team–Patient, Family, and Health Care Providers: An Interprofessional Education Activity Providing Collaborative and Palliative Care

Abstract

The article explains an approach to building interprofessional education (IPE) and interprofessional practice opportunities as well as content in palliative/hospice care within undergraduate and graduate curricula for six health disciplines, including speech-language pathology. Graduate students from nursing, medicine, communication sciences, and disorders, physical therapy, social work and nutrition, as well as undergraduate nursing students participated in one of four IPE training sessions using six videotaped simulation scenes portraying the progression of amyotrophic lateral sclerosis. Learning objectives included (1) engaging in effective interprofessional communication and teamwork, (2) discussing therapeutic patient/family communication, (3) employing supportive holistic care with patients and families at end of life, and (4) relating the patient's physiological assessment findings to the dying process. Students discussed the role of the interprofessional team in end-of-life care and were coached on ways to apply interprofessional communication, a key interprofessional education competency, using patient- and family-centered care principles. Results revealed strong positive agreement among the disciplines regarding the value of the learning opportunities provided during this IPE simulation activity.

Fonoaudiología en cuidados paliativos para adultos y adultos mayores: fundamentos, roles, abordajes y desafíos

“…Desde entonces, su integración a equipos especialistas en cuidados paliativos para personas con enfermedades no oncológicas se mantiene en desarrollo. Dicho proceso se ha acompañado de un progresivo cambio en la percepción de PeCP, familias y otro/as profesionales de la salud, sobre la necesidad de contar con un/a profesional que provea soporte en las dificultades de la comunicación y alimentación experimentadas por la PeCP; siendo actualmente reconocida su labor por diversos documentos y guías clínicas internacionales (Eckman & Roe, 2005;NICE, 2004;Prelock et al, 2017;Royal College of Physicians and British Society of Gastroenterology, 2010). Pese a lo anterior, el valor que se le otorga a aquello/as fonoaudiólogo/as especialistas en cuidados paliativos aún no es del todo reconocido por fonoaudiólogo/as generales, principalmente producto del escaso conocimiento que poseen estos últimos sobre las particularidades del abordaje fonoaudiológico realizado al interior de EdS en cuidados paliativos (Kelly et al, 2016;Toner & Shadden, 2012;Vescovich, 2015).…”

“…En este contexto, es reconocido que las personas que se encuentran al final de su vida viven importantes cambios en su comunicación y alimentación, los que se encuentran presentes incluso en aquellas personas que cursan con condiciones de salud que usualmente no se asocian a este tipo de alteraciones (Kelly et al, 2016). Dicha situación ha derivado en la progresiva inclusión del/la fonoaudiólogo/a en EdS que ofrecen sus servicios bajo el marco de atención de los cuidados paliativos (Aguirre Bravo & Sampallo Pedroza, 2015;Kelly et al, 2016;Prelock et al, 2017). Ello, convoca a estos/as profesionales a desarrollar nuevas competencias y, subsecuentemente, a cambiar el foco de su intervención, migrando desde un abordaje rehabilitador a uno con orientación hacia la prevención y el alivio de síntomas (Kelly et al, 2016).…”

A vivência do enfermeiro nas reuniões multidisciplinares ou interdisciplinares em unidades hospitalares sob a ótica da fenomenologia social de Alfred Schütz

“…Um fator importante, que não foi encontrado nas unidades participantes deste estudo, foi a presença da família nas reuniões formais. No entanto, as reuniões necessitam assegurar participação das famílias, a fim de melhorar o envolvimento da equipe e das famílias (Prelok et al, 2017;Gelvez-Zapata et al, 2015;Wittenberg-Lyles et al, 2012).…”

Early integrated palliative care in the acute care setting

“…Structures used in the acute care setting include but are not limited to: a) Five Wishes (agingwithdignity. org) 100,101 , b) Respecting Choices ® (respectingchoices.org) 77,101,102 , c) the Chronic Care Model which is used also in the acute care setting within the care continuum [103][104][105] , d) components for early integrated PC consultations 106 , e) Clinical Practice Guidelines for Quality Palliative Care in oncology 62 which includes a guidance regarding anticipated disease trajectory and prognosis, f) concurrent or simultaneous care, 14,45,107,108 and g) the "SENS-structure" (which stands for Symptoms, Expectations and end-of-life decisions, Network and Support of the network). 109,110 These structures support the decision making process by anticipating future treatment and care options (ACP), and communicating these through e.g.…”

“…99 This may lead to a partnership within the team that is competency driven 5 rather than professionbound. [100][101][102][103] Basic and ongoing nursing education related to participating in and facilitating the early onset of the ACP process is recommended. 5,53,55 RNs and APRNs need to be well-trained in discussing issues such as a) treatment goals, b) management of symptoms, c) EoL decision making including ACP, d) assessment of patients' social/professional network and e) support needs of caregiver.…”