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Palliative care nepal
- 1. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Welcome
- 2. Vinayak College Of Health Science PCL Nursing 3rd Year 11th Batch
- 3. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Introduction Supportive Care Symptom Oriented Care fatigue, pain, treatment of adverse effects, psychosocial support Patient & family oriented care Upgrade quality of life by active anticipation Spiritual care 3
- 4. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch History First palliative care was develop by wayne state university school of medicine in 1985 in united state. In nepal, palliative care was Started in 1991 in pashupatinath. Established in Bir Hospital after radiotherapy services for cancer patient. 1999 – NGO - Maiti Nepal begun palliative care service for non malignant chronic illness i.e HIV/AIDS. Modern Palliative care for cancer patients in 2000AD with 4 beds through Hospice Nepal. 4
- 5. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch 5 • INCTR /NNCTR Nepal formed palliative care group which was a landmark moment in the development of palliative care in Nepal. • In 2005 committee the morphine is legalized and in 2009 it was manufactured in Nepal.
- 6. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch 2002 – 2007, Many other Palliative Care organization established i.e Bhaktapur cancer Hospital, Maiti Nepal, Navakiran plus 2005 – Patan Hospital begun essential palliative care course, Adopted by Hospice Nepal from Princess Alice Hospice in UK
- 7. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Twinning Programme: Nepal’s Bhaktapur cancer hospital twinned with Canada’s Nanamio community hospice in 2010. Nepal’s Thankot Hospice twinned with Physicians from South Korea in 2011. In 2012 Nepal’s BP Koirala Memorial Cancer hospital twinned with Canada’s Victoria hospice. 7
- 8. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Definition Palliative care (pronounced palle-uh-tiv)is specialized medical care with serious illness which is focused providing relief from the symptoms and stress of a serious illness. According to WHO 8 ”Palliative care is an approach that improve the quality of iife of patients and their families facing the problems associated with life threatning illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological, and spiritual”
- 9. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Palliative care Hospice care Begins at diagnosis , no time frame required. Less than 6 months to live. Hospital, Nursing home Home or as a facility. Life prolonging measures. Doesn’t include curative or life prolonging measures. Terminal illness. May or mayn’t be terminal No time restriction. Life limiting illness. Administered in hospital extended care facilities and nursing homes. Reliance on family and visiting nurses and care is usually provided at home. It is a whole person care that relieves symptoms of disease. It is a palliative care for people who have 6 months or less. 9
- 10. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch
- 11. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Who gives palliative care? Palliative care specialist work as a part of multi-disciplinary team to coordinate the palliative care , team includes: Doctors Nurses 11
- 12. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch
- 13. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Dietician
- 14. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch
- 15. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Purpose Support and care for dying patients. Enhance quality of life. Address the multidimensional need of the dying client . Making Understand dying as a normal process Provide relief from pain & other distressing symptoms Helps patient live as actively as possible until death. 15
- 16. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Principle Patient centered care Management of symptoms Teamwork and partnership with support groups Appropriate ethical consideration Respect for patients autonomy, choice and adequate access to information. High priority should be given to alleviation. Create respectful and trusting relationship Integrate and respect patients cultural values, belief, customs Offer continuity of care. 16
- 17. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Indication It can be offered to people of any age with serious,life threatning illness, such as: 17
- 18. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch 18
- 19. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Components Enhance the quality of life Relieving pain and other distress Providing practical emotional support Helping patient and family member to organize their lives Facilitating a comfortable & dignified death Maximizing human dignity. Decreasing burdensome transition Assessing & managing symptoms Offering grieve and bereavement support 19
- 20. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Roles of nurse Promoting patient centered care Good communication Provide high quality services Improving the quality of life Identify needs, priorities and preferences Family support Collaboration with team members Relief for mental anguish and social isolation Relief for physical symptoms Good death or dying well 20
- 21. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Pain is an unpleasant sensory and emotional experience associated with actual and potential tissue damage. It is always subjective
- 22. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch ACUTE PAIN It is due to acute injury or illness.it has a definite onset and its duration is limited and predictable .Treatment is directed with or without short term use of analgesic. CHRONIC PAIN It is due to chornic pathological process.it has a gradual onset and may become progressively more severe. TYPES OF PAIN
- 23. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch NONCICEPTIVE PAIN Pain is produced by stimulation of specific sensory receptor. There are 2 types: Somatic pain and visceral pain. NEUROPATHIC PAIN It is caused by peripheral or central nervous system injury .A burning sensation, tingling sensation ,shooting pain. It is less responsive to non opoid and opoid analgesic. Such as headache, abdominal pain, peripheral neuropathy, esophageal pain, skin pain, chest pain etc.
- 24. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Assessment of pain Determine the cause, time and site of the pain. What makes it better or worse? Descibe it. Determine the type of pain Is there a psychological or spiritual component? Grade the pain by number of fingers or pointing on a ruler or other methods ,
- 25. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch TREATMENT OF PAIN Analgesic Reassess need for pain medication and other intervention frequently Repeat grading of pain Investigate any new problems 25
- 26. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Treatment is done in two way 1) PHARMACOLOGICAL Mild pain: Non opoids: Paracetamol, aspirin, ibuprofen Moderate pain: Opoids: tramadol, codine Severe pain: Strong opoid: Morphine, Hydromorphone, Fentanyl, Oxycodone, Methadone Adjuvants: antideeprasants Radiation therapy
- 27. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch 2 )NON PHARMACOLOGICAL 1)Positioning 2)Massage 3)Heat and cold application 4)Music 5)Prayer 6)Distraction 7)Aucupunture 8)Meditation
- 28. Music
- 29. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch Accupunture Distract Therapy
- 30. Vinayak College of Health Science PCL Nursing 3rd Year 11th Batch