Self Directed Learning Package - University of Queensland

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46 • The Palliative Approach ToolkitWriteDocument your actionsDocument enough information to allow others in themultidisciplinary team a clear picture of the clinicalsituation.Avoid general statementsPOOR COMMUNICATIONEvaluation of interventions ‘with effect’ or‘effective’.GOOD COMMUNICATION‘Resident has not reported hallucinationsin the last two hours and physicalplucking at the bed sheets has stopped’.ReviewEvaluate and reassess as necessaryIt is important to evaluate the effectiveness of the care youdeliver to residents.Every time you provide care to a resident, ask yourself:• Does it seem to be effective?• Is it doing any harm?Key PointDelirium can develop quickly, regular assessment isimportant.Regular use of the Confusion Assessment Method(CAM) tool may be more beneficial than frequentbrief subjective impressions.
47 • Self Directed Learning Package - Introductory Registered & Enrolled NurseEnd of life carepathwayTerminal care is care focused on the final days or weeks of life.Thinking PointIn the final scenes of the DVD, Alfred is likely to diewithin days or hours.• Have you experienced the death of a resident?• Were you aware that the resident was dying?• What signs of approaching death did you notice?Residents may experience some or all of the following whenapproaching death:• rapid day to day deterioration that is not reversible• requiring more frequent interventions• becoming semi-conscious with lapses into unconsciousness• increasing loss of ability to swallow• refusing or unable to take food, fluids or oral medications• irreversible weight loss• an acute event has occurred requiring revision of treatmentgoals• profound weakness• changes in breathing patterns. 3What is an end of life care pathway?An end of life care pathway is a set of forms and protocolsthat acts as a ‘road map’ to guide the care provided by doctors,nurses and careworkers in the last week of a resident’s life.There are several pathways used in RACFs and hospitals.We recommend the ‘Residential Aged Care End of Life CarePathway (RAC EoLCP)’. This pathway can be downloaded fromthe “PA Toolkit: Forms CD”.
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Self Directed Learning Package - University of Queensland

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