Creation of an institutional protocol for palliative care in a general hospital: a convergent care research

Authors

DOI:

https://doi.org/10.33448/rsd-v11i7.29708

Keywords:

Interconsultation Team; Palliative care; Protocols.

Abstract

In view of the need to diminish/amenify situations of physical and emotional suffering of patients and family members dealing with life threatening diseases, the objective of this study was to develop an institutional protocol of Palliative Care directed to the hospital environment. This is a research of qualitative approach of the assistential convergent type, from the experience of a Nursing Resident, together with the support of the Working Group on Palliative Care of a hospital in the interior of Rio Grande do Sul. Study groups and conversation rounds were held in order to define the team's objectives, criteria for the insertion of patients, their evaluations and follow-up, culminating in the creation of the protocol. It was defined that the group will act as a hospital inter-consultation team that will be activated upon the request of any senior health professional. The initial assessment of the patient will be done by a nurse, a physician and a psychologist, and the initial scales that will assess prognosis and symptoms respectively will be the Paliattive Performance Scale (PPS) and the Edmonton Symptom Assessment Scale (ESAS). A personalized discharge planning will also be carried out focusing on the patient's needs, actions to be directed to the family and activation of the care network. From this study one can expand research on the implementation of PC programs within the hospital environment, as well as modify the institutional culture, bringing to light such a relevant topic.

References

Abreu, A. I. S. C. de S., & Costa Júnior, Á. L. (2018). Sobrecarga do cuidador familiar de paciente oncológico e a enfermagem. Rev. Enferm. UFPE on Line, 976–986. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-970522

Academia Nacional de Cuidados Paliativos. (2018). Análise situacional e recomendações da ANCP para o desenvolvimento dos Cuidados Paliativos no Brasil. Paliativo.org.br. https://api-wordpress.paliativo.org.br/analise-situacional-recomendacoes-ancp-desenvolvimento-cuidados-paliativos-brasil/

Alves, R. S. F., Cunha, E. C. N., Santos, G. C., & Melo, M. O. (2019). Cuidados Paliativos: Alternativa para o Cuidado Essencial no Fim da Vida. Psicologia: Ciência E Profissão, 39. https://doi.org/10.1590/1982-3703003185734

Báo, A. C. P., Amestoy, S. C., Moura, G. M. S. S. de, & Trindade, L. de L. (2019). Quality indicators: tools for the management of best practices in Health. Revista Brasileira de Enfermagem, 72(2), 360–366. https://doi.org/10.1590/0034-7167-2018-0479

Brinkman-Stoppelenburg, A., Witkamp, F. E., van Zuylen, L., van der Rijt, C. C. D., & van der Heide, A. (2018). Palliative care team consultation and quality of death and dying in a university hospital: A secondary analysis of a prospective study. PLOS ONE, 13(8), e0201191. https://doi.org/10.1371/journal.pone.0201191

Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6–9. https://pubmed.ncbi.nlm.nih.gov/1714502/

Carratalá, J. M., Peña-Pardo, B., Gil, V., & Jacob, J. (2020). Oxigenoterapia y cuidados paliativos en pacientes con insuficiencia cardiaca. Rev. Esp. Cardiol. (Ed. Impr.), 598–598. https://pesquisa.bvsalud.org/portal/resource/pt/ibc-ET1-6245

Castilho, R. K., Silva, V. C. S. da, & Pinto, C. da S. (Eds.). (2021). Manual de Cuidados Paliativos da Academia Nacional de Cuidados Paliativos (ANCP) (3rd ed.).

Costa-Requena, G., Cristófol, R., & Cañete, J. (2011). Caregivers’ morbidity in palliative care unit: predicting by gender, age, burden and self-esteem. Supportive Care in Cancer, 20(7), 1465–1470. https://doi.org/10.1007/s00520-011-1233-6

Hua, M., Lu, Y., Ma, X., Morrison, R. S., Li, G., & Wunsch, H. (2020). Association Between the Implementation of Hospital-Based Palliative Care and Use of Intensive Care During Terminal Hospitalizations. JAMA Network Open, 3(1), e1918675. https://doi.org/10.1001/jamanetworkopen.2019.18675

Maia, M. A. de Q., Lourinho, L. A., & Silva, K. V. (2021). Competências dos profissionais de saúde em cuidados paliativos na Unidade de Terapia Intensiva adulto. Research, Society and Development, 10(5), e38410514991. https://doi.org/10.33448/rsd-v10i5.14991

Mechler, K., & Liantonio, J. (2019). Palliative Care Approach to Chronic Diseases. Primary Care: Clinics in Office Practice. https://doi.org/10.1016/j.pop.2019.05.008

Miller, N., Shuler, J., Hayley, D., He, J., Porter-Williamson, K., & Kalender-Rich, J. (2018). Across the Continuum: How Inpatient Palliative Care Consultations Are Reported in Hospital Discharge Summaries. Journal of Palliative Medicine, 21(1), 85–88. https://doi.org/10.1089/jpm.2016.0539

Monteiro, D. da R., Almeida, M. de A., & Kruse, M. H. L. (2013). Tradução e adaptação transcultural do instrumento Edmonton Symptom Assessment System para uso em cuidados paliativos. Revista Gaúcha de Enfermagem, 34(2), 163–171. https://doi.org/10.1590/s1983-14472013000200021

Naaktgeboren, M. W., Magdelijns, F. J. H., Janssen, D. J. A., & van den Beuken-van Everdingen, M. H. J. (2021). Added Value of Early Consultation of an Inpatient Palliative Care Team in Hospitalized Older Patients With High Symptom Burden: A Prospective Comparative Study. The American Journal of Hospice & Palliative Care, 38(10), 1258–1264. https://doi.org/10.1177/1049909120982606

Pask, S., Pinto, C., Bristowe, K., van Vliet, L., Nicholson, C., Evans, C. J., George, R., Bailey, K., Davies, J. M., Guo, P., Daveson, B. A., Higginson, I. J., & Murtagh, F. E. (2018). A framework for complexity in palliative care: A qualitative study with patients, family carers and professionals. Palliative Medicine, 32(6), 1078–1090. https://doi.org/10.1177/0269216318757622

Pegoraro, M. M. de O., & Paganini, M. C. (2019). Cuidados paliativos e limitação de suporte de vida em terapia intensiva. Revista Bioética, 27(4), 699–710. https://doi.org/10.1590/1983-80422019274353

Peirano, G., Bertolino, M., Rodriguez, M., Bunge, S., Armesto, A., & Dran, G. (2019). Interconsultas de cuidados paliativos para pacientes con cáncer en un hospital general: Características y oportunidad. Medicina (B.Aires), 337–344. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1056728

Picollo, D. P., & Fachini, M. (2018). A atenção do enfermeiro ao paciente em cuidado paliativo. Rev. Ciênc. Méd., (Campinas), http://dx.doi.org/10.24220/2318-0897v27n2a3855. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-980808

Pinto, A. C., Silva, A. M. O. P., Arantes, A. C. L. Q., Américo, A. F. Q., Andrade, B. A., Kira, C. M., Burlá, C., Naylor, C., Matsumoto, D. Y., Azevedo, D. L., Forte, D. N., Genezini, D., Franck, E. M., Fernandes, E. A., Aitken, E. V. P., Azevedo, E. F., Aires, E. M., Ribas, E., Chino, F. T. B. C., (...) Hatanaka, V. M. A. (2012). Manual de Cuidados Paliativos da Academia Nacional de Cuidados Paliativos (ANCP. (2a ed.).

Resolução n 41 de 31 de outubro de 2018, (2018). https://bvsms.saude.gov.br/bvs/saudelegis/cit/2018/res0041_23_11_2018.html

Sales Maciel, M. G., & Tavares de Carvalho, R. (n.d.). A Escala de Desempenho em Cuidados Paliativos versão 2 (EDCP v2) TRADUÇÃO BRASILEIRA PARA A LÍNGUA PORTUGUESA (Portuguese Brazilian translation of Palliative Performance Scale (PPS version 2). Retrieved April 27, 2022, from https://victoriahospice.org/wp-content/uploads/2019/07/pps_-_portuguese_brazilian_-_sample.pdf

Santos, R. da S., Pasklan, A. N. P., Vale, I. S., Leitão, I. E. S., Barros, B. F. M., Santiago, F. A. de O., & Lima, S. F. (2021). Percepção de cuidados paliativos dos profissionais de saúde no ambiente hospitalar do município de Pinheir-MA. Revista de Atenção à Saúde, 19(69). https://doi.org/10.13037/ras.vol19n69.7807

Santos, R. S., Lima, F. M., Hora, J. C., & Leão, D. B. (2020). Indicadores de qualidade aplicados na assistência de enfermagem em cuidados paliativos: Revisão integrativa da literatura. Enfermagem Em Foco, 11(2). https://doi.org/10.21675/2357-707x.2020.v11.n2.2652

Saunders, S., Killackey, T., Kurahashi, A., Walsh, C., Wentlandt, K., Lovrics, E., Scott, M., Mahtani, R., Bernstein, M., Howard, M., Tanuseputro, P., Goldman, R., Zimmermann, C., Aslakson, R. A., & Isenberg, S. R. (2019). Palliative Care Transitions From Acute Care to Community-Based Care—A Systematic Review. Journal of Pain and Symptom Management, 58(4), 721-734.e1. https://doi.org/10.1016/j.jpainsymman.2019.06.005

Silva, M. A. dos S., Diniz, M. A., Carvalho, R. T. de, Chiba, T., & Mattos-Pimenta, C. A. de. (2020). Palliative care consultation team: symptom relief in first 48 hours of hospitalization. Revista Brasileira de Enfermagem, 73(6). https://doi.org/10.1590/0034-7167-2019-0391

Sleeman, K. E., de Brito, M., Etkind, S., Nkhoma, K., Guo, P., Higginson, I. J., Gomes, B., & Harding, R. (2019). The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions. The Lancet Global Health, 7(7), e883–e892. https://doi.org/10.1016/s2214-109x(19)30172-x

Soares, L. G. L., Japiassu, A. M., Gomes, L. C., & Pereira, R. (2017). Post-Acute Care Facility as a Discharge Destination for Patients in Need of Palliative Care in Brazil. American Journal of Hospice and Palliative Medicine®, 35(2), 198–202. https://doi.org/10.1177/1049909117691280

Trentini, M., Paim, L., & Silva, D. M. G. V. da. (2014). Pesquisa convergente assistencial - PCA: delineamento provocador de mudanças nas práticas de saúde (3rd ed.).

World Health Organization (WHO). (2018). Palliative Care. https://www.who.int/en/news-room/fact-sheets/detail/palliative-care

Published

21/05/2022

How to Cite

BASEGIO, K. G. .; BENDER, M. S. .; ROSA, A. B. .; MENEZES, R. M. .; GAEDKE, M. Ângela. Creation of an institutional protocol for palliative care in a general hospital: a convergent care research. Research, Society and Development, [S. l.], v. 11, n. 7, p. e20811729708, 2022. DOI: 10.33448/rsd-v11i7.29708. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/29708. Acesso em: 19 apr. 2024.

Issue

Section

Health Sciences