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9. WHOLE HOSPITAL POLICY
9.1 The Palliative Care Unit shall comply with the Whole Hospital Policy in the following areas:
9.1.1 Hospital admission and discharge 9.1.2 Transportation service
9.1.3 Infection control 9.1.4 Sterilization service
9.1.5 Management of waste products 9.1.6 Supply of pharmaceuticals and consumables
9.1.7 Acquisition of assets and equipment 9.1.8 Catering service
9.1.9 Laundry and Linen supply 9.1.10 Cleaning service
9.1.11 Engineering service including preventive and maintenance services
9.1.12 Security service 9.1.13 Fire precaution
9.1.14 Medical record management 9.1.15 Communication system
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9.1.16 Quality Assurance 9.1.17 Occupational and Safety Health Assurance OSHA
9.1.18 Public relations, release of information and conidentiality. 9.2 With regards to palliative care drugs, certain drugs may be used for
indication outside that of standard hospital policy blue book indication. This is acceptable provided the indication is supported
by evidence in current palliative medicine literature and approved by the relevant authorities. A list of essential medications for palliative
care and their indications is provided in Appendix 9. 9.3 All patients in the hospital who have incurable and progressively
fatal illness should have a care plan outlined by the specialist in charge with or without the assistance of a palliative care team. The
patient’s prognosis and issues of CPR, intubation, ICU admission in the event of rapid deterioration and cardio-respiratory collapse
due to their illness should be discussed with the patient andor family and clearly documented in the patient’s clinical notes. Resuscitation
status is a medical decision and should be made by the treating clinicians. Discussions regarding this should therefore not imply that
the family is being asked to make such a decision but merely to inform and understand the rationale for such a decision being made.
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Appendix 1
WHO DEFINITION OF PALLIATIVE CARE
Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness,
through the prevention and relief of sufering by means of early identiication, impeccable assessment and treatment of pain and other problems, physical,
psychosocial and spiritual. Palliative care;
• provides relief from pain and other distressing symptoms. • airms life and regards dying as a normal process.
• intends neither to hasten or postpone death. • integrates the psychological and spiritual aspects of patient care.
• ofers a support system to help patients live as actively as possible until death.
• ofers a support system to help the family cope during the patients illness and in their own bereavement.
• uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated.
• will enhance quality of life, and may also positively inluence the course of illness.
• is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy
or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.
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WHO DEFINITION OF PALLIATIVE CARE FOR CHILDREN
Palliative care for children represents a special, albeit closely related ield to adult palliative care. WHO’s deinition of palliative care appropriate for
children and their families is as follows; the principles apply to other paediatric chronic disorders WHO; 1998a:
• Palliative care for children is the active total care of the child’s body, mind and spirit, and also involves giving support to the family.
• It begins when illness is diagnosed, and continues regardless of whether or not a child receives treatment directed at the disease.
• Health providers must evaluate and alleviate a child’s physical, psychological, and social distress.
• Efective palliative care requires a broad multidisciplinary approach that includes the family and makes use of available community
resources; it can be successfully implemented even if resources are limited.
• It can be provided in tertiary care facilities, in community health centres and even in children’s homes.
DEFINITION OF PALLIATIVE MEDICINE
The medical speciality which concerns itself with the appropriate medical care of patients with progressive disease. This should be distinguished from
“Palliative Care” which is the approach to care for patients with progressive disease.
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Appendix 2
PRINCIPLES OF PALLIATIVE CARE MANAGEMENT 1. Scope of care
Includes patients of all ages with life-threatening illness, conditions or injury requiring symptom relief from physical, psychosocial and spiritual
sufering.
2. Timing of palliative care
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