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Palliative care for cancer patients in the UK is well established - but the situation isstarkly different for those suffering from heart failure . A recent service evaluation led by the University of Hull andHull York Medical School (HYMS) shows this doesn't have to be thecase - particularly if clinicians have the courage to talk aboutdeath with their patients. The study - published in the British Journal of Cardiology - describes data from two areas in Yorkshire where palliative careand heart failure services are fully integrated - Bradford &Airedale and Scarborough. The results show that integrated teamwork can reduce unwanted hospital deaths for heart failurepatients, enabling many to die where they prefer. The study was led by Dr Miriam Johnson, Reader in PalliativeMedicine at the University of Hull and HYMS and Honorary consultantat St. Catherine's Hospice, Scarborough: "There's long been aperception that you can't talk to heart failure patients aboutdeath mainly because it's seen as difficult to predict whenpatients are close to end of life. However, our work shows thatmany heart failure patients are able to have honest discussionswith their clinicians about their prognosis and appreciate theopportunity it provides for them to make plans and set theiraffairs in order." The team found that heart failure specialist nurses were able torecognise when patients were nearing end of life in the vastmajority of cases and discuss the issues with them. Over two thirdsof patients put plans in place for end of life and stated wherethey wished to die - most choosing to be at home - and theirpreferred place of death was achieved in 61% of cases. Over half of all patients accessed specialist care servicescompared to the 2011 National Audit Office figures of just 4%overall in the UK, but Dr Johnson stresses that the nationalfigures are not completely reliable. "Unfortunately the systems in hospitals for registering wherepatients access palliative care aren't well-established, so we needto take these figures with a pinch of salt," she said. "However,the lack of good reporting mechanisms itself may indicate that manyhospitals do not perceive palliative care provision for their heartfailure patients as a priority." In the services assessed for the study, much of what would becalled palliative or end of life care was actually delivered by thespecialist cardiology nurses and Dr Johnson says this aspect isvery important when managers are looking at designing anddeveloping similar services. "The specialist nurses hold a pivotal position within theintegrated services," she says. "They have an ongoing relationshipwith patients both in hospital settings and in the community and soare best able to judge when patients are nearing end stage disease,are best placed to have those difficult conversations withpatients, bring in specialist palliative care clinicians wherenecessary, and are on hand to help ensure patients' preferences aretaken into account. "However, although this means that it is often within the skills ofcardiology teams to deliver palliative care to their patients, theextra time nurses need to spend with patients to work through thesedifficult decisions must be taken into account when managingworkload." Additional References Citations. The e-commerce company in China offers quality products such as China Manual Mp4 Multimedia Player , China Mp5 Game Portable Multimedia Player, and more. For more , please visit Mp3 Player with Microsd Card Slot today!
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