Palliative Care and Pain Management at the End of Life
Course #97384 - $90 -
- Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
This course is designed to bridge the gap in knowledge of palliative care by providing an overview of the concept of palliative care and a discussion of the benefits and barriers to optimum palliative care at the end of life. Central to this discussion is an emphasis on the importance of talking to patients about the value of palliative care, of clearly presenting the prognosis and appropriate treatment options and goals, and of ensuring that advance planning is completed. The majority of the course focuses on the assessment and management of the most common end-of-life symptoms, with particular attention to pain, the most prevalent, as well as the most distressing, physical symptom. Psychosocial and spiritual needs of the patient and family are also discussed. Palliative care presents unique challenges for some patient populations, most notably older patients, children/adolescents, and patients receiving critical care. An overview of the most important issues specific to these settings is provided.
This course is designed for all members of the interprofessional team, including physicians, physician assistants, nurse practitioners, nurses, pharmacists, pharmacy technicians, social workers, marriage and family therapists, and other members seeking to enhance their knowledge of palliative care.
The purpose of this course is to provide an overview of the concept of palliative care as distinct from hospice care, including a discussion of challenges, benefits, and strategies for optimal palliative care and symptom management at the end of life.
Upon completion of this course, you should be able to:
- Describe how the definition of palliative care has evolved.
- Define the structure of palliative care delivery, including models of care and the interdisciplinary healthcare team.
- List the benefits of palliative care at the end of life.
- Anticipate the barriers to optimum delivery of palliative care through hospice.
- Effectively engage the components of communication and decision making for end-of-life care.
- Identify the common concerns and symptoms at the end of life for patients with life-limiting diseases.
- Discuss the barriers to effective relief of pain at the end of life.
- Assess pain accurately through use of clinical tools and other strategies.
- Select appropriate pharmacologic and/or non- pharmacologic therapies to manage pain in patients during the end-of-life period.
- Assess and manage the most common symptoms (other than pain) experienced by patients during the end-of-life period.
- Evaluate the psychosocial needs of patients at the end of life and their families and provide appropriate treatment or referral.
- Recognize and address the spiritual needs of patients at the end of life and provide appropriate treatment or referral.
- Develop a strategy for providing care to patients and their families over the last days and hours of life.
- Support appropriate grief and mourning.
- Explain the specific challenges and ethical considerations in delivering optimum palliative care to older patients, children, and patients in critical care settings.
John M. Leonard, MD, Professor of Medicine Emeritus, Vanderbilt University School of Medicine, completed his post-graduate clinical training at the Yale and Vanderbilt University Medical Centers before joining the Vanderbilt faculty in 1974. He is a clinician-educator and for many years served as director of residency training and student educational programs for the Vanderbilt University Department of Medicine. Over a career span of 40 years, Dr. Leonard conducted an active practice of general internal medicine and an inpatient consulting practice of infectious diseases.
Contributing faculty, John M. Leonard, MD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
John V. Jurica, MD, MPH
Mary Franks, MSN, APRN, FNP-C
Alice Yick Flanagan, PhD, MSW
Margaret Donohue, PhD
Randall L. Allen, PharmD
The division planners have disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Sarah Campbell
The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.
Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.
It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.
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The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.
Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.