Annals of palliative medicine
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Case Reports
A values-based conceptual framework for surgical appropriateness: an illustrative case report.
Appropriateness in surgical decision-making necessitates that surgical treatments are aligned with patients' goals and values for care. To arrive at informed decisions for surgery, patients must have an understanding of post-operative recovery, the impact on quality of life, and expected functional outcomes. ⋯ Palliative care needs that arose during the course of the patient's treatment are identified and described, revealing opportunities for better integration between palliative and postoperative care. A conceptual framework for measuring appropriateness in surgery, which incorporates patients' goals, values and preferences for medical treatments, is proposed.
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In 2000, the City of Hope Medical Center and the American Association of Colleges of Nursing (AACN) developed the End-of-Life Nursing Education Consortium (ELNEC)-Core curriculum to educate nurses and other healthcare professionals on end of life care, so that attention to the dying could be improved and their unique needs addressed. Since its inception, over 19,500 nurses and other professionals have attended the ELNEC train-the-trainer courses. Upon course completion, the participants, often nurse educators, returned to their schools, healthcare systems, and communities and introduced the ELNEC content into nursing curricula, annual competencies, and new employee orientation. ⋯ The first ELNEC International course was launched in 2006 in Salzburg, Austria. Since that time, trainers have come from 85 countries world-wide, and the curriculum has been translated into eight languages. In 2015, three international courses will be presented: in Beijing, China, Kipkaren, Kenya, and Salzburg, Austria.