Evidence-Based Practice Recommendations
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- Review the course material online or in print.
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The Institute for Clinical Systems Improvement asserts that clinicians caring for patients with serious illness should examine their own cultural values and assumptions about what constitutes "good" care for patients nearing the end of life, recognizing not all patients will share these same values, and ensure goals and decisions remain centered around the patient's values/beliefs.
(https://www.icsi.org/wp-content/uploads/2021/11/PalliativeCare_6th-Ed_2020_v2.pdf Last Accessed: October 14, 2024)Level of Evidence: Expert Opinion/Consensus Statement
The Institute for Clinical Systems Improvement recommends that palliative care discussion or referral should be considered whenever a patient develops or presents with a serious or life-threatening illness, in all care settings.
(https://www.icsi.org/wp-content/uploads/2021/11/PalliativeCare_6th-Ed_2020_v2.pdf Last Accessed: October 14, 2024)Level of Evidence/Strength of Recommendation: Low-Quality Evidence, Strong Recommendation
According to the Institute for Clinical Systems Improvement, there needs to be shared decision-making with the patient about reducing or eliminating opioids to avoid unnecessary complications from long-term opioid use. This involves following and re-evaluating the patient closely, with dose reduction or discontinuation as needed.
(https://www.icsi.org/wp-content/uploads/2021/11/PalliativeCare_6th-Ed_2020_v2.pdf Last Accessed: October 14, 2024)Level of Evidence: Expert Opinion/Consensus Statement
According to the Institute for Clinical Systems Improvement, short-term psychotherapy modalities (e.g., dignity therapy) can provide reduction in depression and anxiety symptoms at the end of life.
(https://www.icsi.org/wp-content/uploads/2021/11/PalliativeCare_6th-Ed_2020_v2.pdf Last Accessed: October 14, 2024)Level of Evidence: Expert Opinion/Consensus Statement
It is important to differentiate grief from depression. Grieving can be an appropriate response to loss, but if the symptoms persist, the Institute for Clinical Systems Improvement recommends that depression be considered.
(https://www.icsi.org/wp-content/uploads/2021/11/PalliativeCare_6th-Ed_2020_v2.pdf Last Accessed: October 14, 2024)Level of Evidence: Expert Opinion/Consensus Statement
The British Columbia Medical Services Commission asserts that the relationship between the physician and the patient is one of the most potent therapeutic tools for assisting patients who are dealing with grief. Reassurance about the normal pattern of grief and a commitment to supporting the patient in an ongoing way is the mainstay of care. It may involve scheduled follow-up visits as necessary.
(https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/palliative3.pdf Last Accessed: October 14, 2024)Level of Evidence: Expert Opinion/Consensus Statement
The American Association of Neuroscience Nurses recommends that nurses evaluate parents' overall concerns related to their child's end-of-life trajectory and address those concerns when planning care. Parents should be educated about symptoms that may be observed during their child's end of life, especially signs of possible impending death.
(https://bibliosjd.wordpress.com/wp-content/uploads/2015/02/aann13_pbt_e.pdf Last Accessed: October 14, 2024)Level of Evidence: Level 3 (Recommendations are supported by qualitative study, case study or series, expert committee reports, and/or expert opinion)
- Back to Course Home
- 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.