Ateneo - UPO

Concepts of nursing care aimed at the person at the end stage of life

Cesarina Prandi - Infermieristica in cure palliative - Ed. EDRA - 2015

At the end of the course, the student will be able to - design and implement a care plan for the person in the terminal phase of life - identify nursing care priorities in people with advanced and poor prognosis diseases

The student must demonstrate autonomous clinical judgement; communication skills to plan and describe the implementation of individualised care, autonomously using diagnostic reasoning and the knowledge acquired during the course of study

Lectures
Discussion of clinical cases
Small group work

Students with disabilities or Specific Learning Disorders (DSA) or Special Educational Needs (BES) may request specific services and tools dedicated to them by contacting the Career Development and Coordination Staff and Student Services and consulting the dedicated page on the University website: https://uniupo.it/it/servizi/servizi-studenti-disabili-e-dsa
Students with disabilities, DSA, BES, once they have made contact with the University Staff, they can contact the teacher in charge of the teaching programme in relation to the declination of examination methods, with regard to teaching aspects.

The examination consists of a written test and an oral test. The written test aims to assess the candidate's level of knowledge and understanding of the subjects covered. The written test, administered online, consists of 42 multiple-choice questions on medical subjects and venous access management. Passing this test (60% of the total questions) allows access to the oral test on the subjects of nursing in oncology and hematology, and end-of-life care nursing. The oral examination, which takes place 5-15 days after the written exam, aims to assess the student's ability to independently use diagnostic reasoning, applying the knowledge they have learned and demonstrating their ability to engage in an in-depth discussion on aspects of care specific to people with neoplastic diseases and people at the end of life. The final grade will be the average of the written exam and the average of the oral exam.

Module 1 - Introduction to the terminal phase of life
- Palliative care: history, principles, places
- The terminally ill person
- The palliative care system: legislation
- The actors in palliative care: professions, multidisciplinarity
Module 2 - The care needs of the terminally ill person
- The assessment of the person's care needs
- The planning of care
- The assessment of the care needs of the family/significant persons
- The quality of life
- The developmental trajectories of diseases
Module 3 - Nursing care in the terminal phase
- Concept of complexity of care in the terminal phase
- Concept of evolving care needs in the terminal phase of life
- Framing main symptomatological pictures
- Pain: framing and treatment
- Palliative care issues in palliative care: oral cavity, nutrition, hydration, elimination, sleep, ADLs, skin integrity, self-care, infections, adaptation and reactions to treatments
- Hints on child care in palliative care
Module 4 - The caring relationship
- Nursing caring in palliative care: caring, person-centered approaches, recall of primary nursing
- Empathy: definition, components, process, precursors, errors
- The relationship with the person and family: verbal, nonverbal, helping, silence
- The family: function, support, need
- The communication of bad news
- The accompaniment at the end of life
- Bereavement (of those left behind)
Module 5 - The holistic approach
- Social needs: caregivers, social networks, social workers
- Spiritual aspects
- The ethics of care: planning, DAT, expression of wishes
- Storytelling in palliative care
- Complementary treatments in palliative care

Module 6 - The quality of palliative and end-of-life care
- Appropriateness in palliative care
- Quality standards and evidence of effectiveness in palliative care
- The use of evidence to support clinical decisions in palliative care
- Emergencies in palliative care: hemorrhage, mediastinal syndrome, delirium, seizures, spinal cord compression, hypercalcemia, etc.
- Palliative and/or terminal sedation
Module 7 - Methodological and organizational aspects.
- Palliative care settings: when, where, to whom?
- Reflective practice
- The education of nurses in palliative care.
- The core curriculum of the palliative care nurse

The following are the expected outcomes of this discipline: - Knowledge and understanding (knowledge and understanding). Students upon completion of this course will be able to: -know caring strategies - know the factors related to the condition of the ill i advanced and/or palliative stage - know the psychosocial needs of the person with terminal illness. This knowledge is acquired during theoretical lectures and case discussions and is assessed during learning assessments -Ability to apply knowledge and understanding ) applying knowledge and understanding) Students at the end of the course will be able to: - recognize the signs and symptoms characteristic of the advanced stage of disease and resulting from related treatments - recognize and know how to implement the best care strategies in the terminal illness phase - Know how to apply diagnostic reasoning, using the knowledge provided by the course, in identifying the needs of the palliative and/or terminal patient - Know how to formulate a care plan with related goals and interventions, aimed at the palliative and/or terminal patient These skills are acquired during theoretical lectures and case discussions and are assessed during learning assessments - Judgment skills (making judgement Students at the end of the course will be able to: - Be able to present in oral form appropriate considerations of the diagnostic reasoning conducted and the resulting care plan designed, the method used, the interventions planned, and the expected results. - To know how to use terminology appropriate to the clinical description to be presented. These skills are acquired during theoretical lectures and case discussions and are assessed during learning reviews