Improving end-of-life care through quality improvement.

Although end of life (EoL) care has been identified as an area for quality improvement in hospitals, the quality of care Canadian patients receive at the end of life is not well-evidenced. National statistics indicate that Canadians would prefer to die at home, yet more than 50% die in acute care hospital settings. Busy and often highly specialised acute care units may be perceived as a distressing place of death for both patients and their families.

An interprofessional education programme for medical learners during a one-month palliative care rotation.

Interprofessional education in health care and in palliative care has been the focus of increasing attention in recent years. For health professionals to provide and deliver high-quality palliative care, collaboration and teamwork is required. Palliative care is the ideal service to introduce interprofessional teamwork to medical learners early on in their training.

Enhancing communication in end-of-life care: a clinical tool translating between the Clinical Frailty Scale and the Palliative Performance Scale.

Objectives: To create a clinical tool to translate between the Clinical Frailty Scale (CFS), which geriatrics teams use, and Palliative Performance Scale (PPS), which palliative care teams use, to create a common language and help improve communication between geriatric and palliative care teams.

Design: Cross-sectional.

Settings: Two academic health centers: inpatient palliative care and chronic care units, an outpatient geriatric clinic, and inpatient referrals to a palliative care consultation service.

Nurses' experiences caring for patients and families dealing with malignant bowel obstruction.

Malignant bowel obstruction (MBO) is a well-recognised complication of advanced abdominal and pelvic cancers. Often surgical intervention is not feasible, resulting in complex symptoms and an unpredictable course. Although symptom management is a crucial part of nursing care, psychosocial and emotional issues frequently emerge for patients and families.

What do symptom scores mean: observations on discrepancies when defining symptoms using words and numbers.

Unlabelled: The Edmonton Symptom Assessment System (ESAS) has become a more frequently used tool for symptom screening in oncology and palliative care settings in Ontario. The process patients use to select symptom scores however is poorly understood.

Purpose: The purpose of this paper is to consider what patients mean when assigning numbers or words to symptoms, and the implications for healthcare providers who interpret these responses.

Addressing the sexual health needs of patients with gynecologic cancers.

Research indicates that sexual health and function frequently are overlooked by healthcare professionals despite being identified as an essential aspect of patient care. This article discusses the topic of sexuality as it pertains to women with gynecologic cancers, highlights barriers to addressing sexuality with patients with cancer, and provides nurses with a framework to guide them in providing information and support to patients who are experiencing sexual difficulties or who need information about sexual function. A case study addresses the challenges a woman with cervical cancer faces and the role of the nurse in supporting the patient and her partner within the PLISSIT model.

Pain management at the end of life in a patient with renal failure.

Literature indicates that an essential element of a 'good' death is the absence of pain. Achieving a pain-free death for the patient who discontinues dialysis is a goal shared by patient, family and care providers. Pain management at end of life can be challenging, especially in the setting of renal failure.