Collaborations in Palliative Care
Transcript of Collaborations in Palliative Care
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
Selamat Datangdi Yuminar
(Zoom Seminar)
KULIAH ONLINE MST KEPERAWATAN POLTEKES- Collaboration in Palliative Care -
13 JUNI 2020
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
dr. Ika Syamsul Huda MZ, MPH, SpPDKetua Tim Perawatan PaliatifRSUP dr. Kariadi Semarang
KOLABORASIPADA PERAWATAN PALIATIF
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
Mapping levels of palliative care development in 198 countries: the situation in 2017
Prof. David Clark, dkk 2017
INDONESIA: Isolated Palliative Care Provision
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A country in this category is characterized by the development of palliativecare activism that is still patchy in scope and not well-supported; sources of
funding that are often heavily donor-dependent; limited availability ofmorphine; and a small number of palliative care services that are limited in
relation to the size of the population.
INDONESIA: Isolated Palliative Care Provision
Prof. David Clark, dkk 2017
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ICD-10 Version:2019 https://icd.who.int/browse10/2019/en#/Z51.5
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
Isu Aktual
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http://www.who.int/en/news-room/fact-sheets/detail/palliative-care
PALLIATIVE CARE IS REQUIRED FOR A WIDE RANGE OF DISEASES
35.50% 34%
10.30%5.70%
4.60%9.90%
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Perawatan Paliatif
PALLIATIVE, END OF LIFE AND BEREAVEMENT CARE
http://www.jpalliativecare.com/articles/2010/16/3/images/IndianJPalliatCare_2010_16_3_107_73639_f1.jpg
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What is the moment to start palliative care?https://bjgp.org/content/62/602/e625
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KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
http://www.who.int/cancer/palliative/definition/en/
WHO Definition of Palliative Care
Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
TOTAL PAINTotal pain recognisespain as being physical, psychological, social and spiritual.
Dame Mary Cicely Saunders
INTERDISCIPLINARYTEAMWORK IN PALLIATIVE CARE
Dame Mary Cicely Saunders(22 Juni 1918 - 14 Juli 2005)
Hospice care movement
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DO NOT FORGET THAT PAINIS NOT ALWAYS PHYSICAL
https://www.hospicetaranaki.org.nz/media/1069/generalistguidelineshti-march-2014.pdf
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KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
Palliative care can focus on:
❖ controlling symptoms❖ independence❖ emotional, spiritual and cultural wellbeing❖ planning for the future❖ caring for patient's family and carers
https://www.health.qld.gov.au/news-events/news/what-is-palliative-care-Queensland
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KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
People are ‘approaching the end of life’if they are likely to die within the next 12 months.
People “at the end of life”people who are imminently dying and might be in the last few hours or days of life.
https://www.dyingmatters.org/sites/default/files/user/10Questions.pdf
Masa Akhir Kehidupan
Saatnya menjelang ajal
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The clinical care domains for end of life include: ❑ Advance care planning❑ Recognise end of life❑ Assess palliative care needs❑ Provide palliative care❑ Work together❑ Respond to deterioration❑ Manage dying❑ Bereavement
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INTEGRASI PERAWATAN PALIATIF
PASIEN
TIM PALIATIF
KELUARGA DAN
PERUMAT(CARE GIVER)
MASYARAKAT DAN
KOMUNITAS
MANAJEMEN DAN
FASILITAS
DPJP
(CURATIVE CARE)
KERJASAMA TIM
PALLIATIVE CARE
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TIM PERAWATAN PALIATIF RUMAH SAKIT
• Dokter• Perawat• Fisioterapis• Rohaniawan• Pekerja sosial• Farmasis• …
MultidisiplinerKolaborasiKoordinatif
Pelayanan perawatan yang terintegrasi
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The ideal multidisciplinary teamrequires→ medical staff→ nursing staff→ social worker→ physiotherapist→ occupational therapist→ chaplain or pastoral care worker
Very useful, but not essential, are→ dietician→ psychologist (or liaison psychiatrist)→ clinical pharmacist→ music and art therapists→ volunteers→ other personnel, as required
https://hospicecare.com/what-we-do/publications/manual-of-palliative-care/
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Delivered by an interdisciplinary team, palliative care adds an extra layer of support by addressing the physical, emotional, psychosocial and spiritual concerns associated with serious and chronic conditions.
https://csupalliativecare.instructure.com/courses/1005/pages/what-is-palliative-care?module_item_id=52419
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Palliative care involves an interprofessional collaborative approach in working with patients and their families and caregivers by providing patient-centered and individualized pain relief compassion, caring, and overall minimization of symptom severity.
https://austinpublishinggroup.com/palliative-care/fulltext/apc-v1-id1006.php
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Interprofessional collaboration occurs when health professionals from different disciplines work together to identify needs, solve problems, make joint decisions on how best to proceed, and evaluate outcomes collectively.
https://pubmed.ncbi.nlm.nih.gov/20925291/
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KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
Interprofessional collaboration supports patient-centred care and
takes place through teamwork.
https://pubmed.ncbi.nlm.nih.gov/20925291/
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Providing good psychosocial care comes down to good communication skills, both verbal and non-verbal.
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Barriers to palliative care implementation, include:
• corporate power (“PC must remain in our service…”); • denial (“we are already doing so…”); • personal (resistance to accept end-of-life care);• misunderstandings (PC seen as death or euthanasia); • competition (“we have been doing so much better over
many years”); and • conflict
https://www.uicc.org/sites/main/files/atoms/files/Gomez-Batiste_X_Connor_S_Eds._Building_Integrated_Palliative_Care_Programs_and_Services._2017.pdf
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In particular, the limits of information sharing have been pointed out as important barriers to the quality of inter-professional collaboration
https://www.oatext.com/inter-professional-communication-in-palliative-care-general-practitioners-and-specialists-in-switzerlandc.php#gsc.tab=0
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PROVIDING A PALLIATIVE APPROACH TO CARE
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INFORMATIONBREAKING BAD NEWSFAMILY SUPPORTADVANCED CARE PLANNING
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1. Pain 2. Anorexia3. Nausea and vomiting4. Constipation5. Diarrhoea6. Dyspnea7. Fatigue8. Delirium9. Depression10. Anxiety11. Respiratory tract secretions
11 SYMPTOMS
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KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
WITHHOLD & WITHDRAWTidak memberikan dan Menghentikan
Obat-obatan, Tindakan dan Pemeriksaanmungkin perlu dipertimbangan untuk tidakdiberikan, dan yang sudah diberikan tidak
diberikan lagi.
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Stopping unnecessary medicationsDecisions about which medications to stop should be made by balancing the likely prognosis from the palliative care diagnosis, with short, medium, and long-term risks associated with stopping medications to manage co-morbidities.
https://www.caresearch.com.au/caresearch/ProfessionalGroups/NursesHubHome/Clinical/MedicationManagement/PalliativeMedications/tabid/1554/Default.aspx
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
deprescribing
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PALLIATIVE CARE
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Rumah sakit menetapkan proses untuk mengelolaASUHAN PASIEN DALAM TAHAP TERMINAL.
Proses ini meliputia) intervensi pelayanan pasien untuk mengatasi nyeri;b) memberikan pengobatan sesuai dengan gejala dan
mempertimbangkan keinginan pasien dan keluarga;c) menyampaikan secara hati-hati soal sensitif seperti autopsi
atau donasi organ;d) menghormati nilai, agama, serta budaya pasien dan keluarga;e) mengajak pasien dan keluarga dalam semua aspek asuhan;f) memperhatikan keprihatinan psikologis, emosional, spiritual,
serta budaya pasien dan keluarga.http://www.pdpersi.co.id/kanalpersi/manajemen_mutu/data/snars_edisi1.pdf
STANDAR NASIONAL AKREDITASI RUMAH SAKIT (Edisi 1)
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Team interactions require trust, confidence and an equal effort by all team members.
https://symbiosisonlinepublishing.com/palliative-medicine-care/palliative-medicine-care16.php
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
Nama:Prof. Raden Sunaryadi Tejawinata,dr. SpTHT(K-Onk), FICS, FAAO, PGD, Pall.Med.(ECU)
Lahir:Cirebon, 23 Agustus 1934
Prof. Sunaryadi
BAPAK PALIATIF INDONESIA
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DEKLARASI PERDOPIN
(Perhimpunan Dokter Paliatif Indonesia)
Surabaya, 22 Februari 2014
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AMAN - LANCAR - SELAMATSAMPAI TUJUAN
KULIAH MST KEPERAWATAN POLTEKES 13 JUNI 2020 – KOLABORASI PADA PERAWTAN PALIATIF
THANK YOU
Palliative Care Indonesia (PCI)https://bit.ly/palliativecareindonesia
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KULIAH KOLABORASI PADA PERAWATAN PALIATIFDownload materi:https://bit.ly/kolaborasiperawatanpaliatif