International journal of palliative nursing
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This retrospective audit assessed the referral practice for patients with end-stage renal failure from the nephrology service to the specialist palliative care team in a large teaching hospital in the north-west of England. ⋯ There was well-established referral practice between the renal and the specialist palliative care team at the hospital examined. The renal team appropriately referred for symptom control and support in the dying phase of patients. There are issues surrounding placement and increased implementation of end-of-life care tools, including the Liverpool Care Pathway, Gold Standards Framework and Preferred Place of Care documentation for renal patients, which needs to be an ongoing priority.
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This article reports on the implementation process and preliminary results of a year-long pilot project providing hospice day care to patients with non-malignant conditions in Dundee, Scotland, UK. With appropriate enthusiasm, planning, consultation, staff education, access via clinical nurse specialist screening, careful referral criteria, goal-setting, an overt discharge policy and close collaboration between clinical nurse specialists, specialist palliative care services and the primary health care team, we were able to offer care to a small number of selected patients perceived to have the greatest need. ⋯ Attendance appeared generally acceptable to patients. The project did not overwhelm the service, had negligible impact upon inpatient admissions and did not require extra funding.
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This article considers the language of spirituality in palliative care (Byrne, 2002; 2007), and focuses on the concepts of metaphor and story, demonstrated in practice by the art project and publication at The Prince & Princess of Wales Hospice (PPWH), Glasgow, UK. Metaphors have been used in everyday speech and literature throughout history. The word 'cancer' is a metaphor itself traced back to Hippocrates in the 5th century BC. ⋯ Stories often include metaphoric images and give an understanding of the uniqueness of individual fear and inner need. Cullen and Alcock describe creative expression as the process of unraveling a story (2007). The creative arts project at PPWH bears witness to this.
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This article will outline the use of continuous subcutaneous infusion pumps, known as syringe drivers, including their benefits and drawbacks in a palliative care context. There have been over 5000 articles published globally describing syringe drivers in the medical and nursing literature within the last decade. Many provide guidance on their use, although much of the data are repetitious, disease or age-group specific, and focused on pragmatic issues to do with clinical application. ⋯ Globally, practitioners in palliative care are very familiar with their use, although the literature lacks specific guidance and, at times, the information is ambiguous. Having briefly reviewed their benefits, the article considers the limitations of using syringe drivers and comments on some of the lesser known/reported practical and patient-focused drawbacks associated with their use. We conclude by considering why, when so much education and training exists to help practitioners use these devices effectively, so many human errors occur.