International journal of palliative nursing
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Review Comparative Study
A description and comparison of palliative care services in the United Kingdom and Czech Republic.
National and international comparative studies on provision of palliative care are lacking and further research would be beneficial for the development of national policies and effective service frameworks in different countries. This literature review focuses on a comparison of the development, structure and provision of the palliative care services in the United Kingdom (UK) and the Czech Republic (CZ). ⋯ The challenges and constraints within the Czech and UK health-care systems preventing delivery of palliative care to all patients with palliative care needs will be identified. The aim is to provide the reader with a simple, but comprehensive picture of palliative care services within the UK and the CZ as they currently exist, offering a building block for possible future research.
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Nurses routinely identify and suggest patients to physicians for possible referral to palliative care and discuss potential referrals with families. Knowledge of palliative care is essential for nurses, especially in paediatrics, where palliative care is less common than with adults. This study uses data from surveys from 279 paediatric nurses across Florida, USA. ⋯ Multivariate analyses show that receiving formal palliative care training and having worked at a hospice were associated with greater knowledge. Paediatric nurses in Florida have a good level of baseline knowledge of palliative care. Nurses' training programs should be used to increase knowledge, which may subsequently lead to more referrals.
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This paper presents a challenging case study that reflects on the ethical and legal obligations of health-care workers. The case raised issues about the rights of terminally ill patients to refuse or reject treatment, and changed practice with the formulation of procedures and guidelines about self-harm, the wider issue of euthanasia, and the responsibilities of health-care workers in such cases. ⋯ At the time of his attempted suicide, he was a patient of a palliative care outreach team at an Austalian hospital. The right of a person to take their own life, respect for autonomy and the actions of health-care workers are the basis of discussion.
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Although the use of subcutaneous infusion is common in palliative care, problems can occur. Normally, butterfly needles are used; however, there are occasional issues with patients being able to walk around or with restless patients who suffer from delirium. In these cases, needles often dislocate; therefore, a small observational study was undertaken to evaluate the use of the Cleo 90 infusion set. ⋯ Reddening and induration of the skin occurred, but they were reversible after removing the needle. As this was a small study in only one unit, without standardization the results can only be observational. However, it has shown, for the first time, that the Cleo 90 needle can be safe and comfortable.