Analysis: Palliative Care Standards, Guidelines, and Case Study

This case study essay analyzes the palliative care provided to Tyler Morton, a 40-year-old ALS patient, focusing on the application of national palliative care standards, NSQHS standards, and NMBA standards. It identifies the selected clinical practice guideline for managing Motor Neuron Disease/ALS and evaluates its drawbacks, particularly the late introduction of community palliative care and poor communication among the patient, healthcare professionals, and family. The essay highlights the importance of adhering to these standards for improving patient care and quality of life, while also addressing the shortcomings that led to the patient's deteriorating condition and eventual passing. The analysis emphasizes the necessity of timely intervention, effective communication, and comprehensive assessment in palliative care settings to ensure optimal patient outcomes. Desklib provides a platform for students to access similar solved assignments and past papers.

CASE STUDY ESSAY

Table of Contents
INTRODUCTION...........................................................................................................................3
Case study overview....................................................................................................................3
MAIN BODY...................................................................................................................................3
Selected clinical practice guideline as per the issue identified in case study..............................3
National Palliative Care Standards..............................................................................................4
NSQHS Standards........................................................................................................................4
NMBA Standards.........................................................................................................................5
Drawbacks of chosen clinical practice guidelines.......................................................................6
CONCLUSION ...............................................................................................................................6
REFERENCES................................................................................................................................1

INTRODUCTION
Nursing can be defined as a healthcare professionals in which care of individuals,
patients, families etc. is taken as per their requirement in order to ensure overall quality of life of
patients (Smets & et. al. 2018). Nursing professionals plays a vital and important role in bringing
improvement within health and quality of life of individuals and patients as well as of their
families. Nursing is one of the most important part of palliative care setting that help healthcare
professionals in fulfilment of needs and requirement of individual ans well as their family
members. This essay will be focusing upon overview of selected clinical practice guideline
applicable to issue identfied in selected case study of Tyler Morton, national palliative care
standards, NSQHS standards, NMBA standards, and drawbacks of selected clinical practice
guideline.
Case study overview
Tyler Morten is a 40 years of person who whistle to take training of a pilot and lives with
his wide and three children. 18 months ago Tyler experienced some weakness in is left hand and
strength of his left hand was not enough as compared to his right hand. Due to this he took an
appropriate with his GP and after various test he was diagnosed with Amyotrophic lateral
sclerosis (ALS). 12 moths ago his condition was still deteriorating, his problem moved from left
hand to right hand and further increased to his leg due to which he had started using a mobility
walking frame. 6 moths ago his condition deteriorated further and due to insufficient nutrition,
his dyspnoea condition deteriorated more and as a result he was provided with community
palliative care to provide assistance in his daily living activities.
MAIN BODY
Selected clinical practice guideline as per the issue identified in case study
Clinical Practice Guideline is a kind of practice or guiding decisions and criteria that
plays a vital and important role in diagnosing and treating modalities in diagnosis and treatment
of patient. It directly help healthcare professionals in taking appropriate and guiding decisions
for enhancement of overall quality of life of patient. In the case study of Tyler due to his
Amyotrophic lateral sclerosis (ALS) condition his health and mobility was deteriorating (Harden
& et. al. 2017). He strength of hands was getting reduced, his movement was also slowly
deteriorating as a result he required. Due to this continuous deteriorating conation and his

physical deteriorating condition increased his concern for his health ans well as due to tension
between his wife and mother is concern were increasing.
CPG chosen which is applicable to the issue identified in Tylor's case is: management of Motor
neuron disease issue of Amyotrophic lateral sclerosis (ALS) disease as it is a kind of motor
neuron disease. This selected CPG has further helped in identifying that following the main
issues in case of Frank.
National Palliative Care Standards
There are various kinds of palliative care standards that are application to Tylor's case.
Palliative care standard 1 focuses upon principle of assessing needs of an individual. This
directly help care providers to understand what are the main needs of individual by assessing
their need spectrum (Watts & et. al. 2021). As per this standard main need of Tylor was to
provide support in his mobility, assessing him in daily routine or living activities and integrate
his care with his family needs by resolving conflict between his wife and mother. On the basis of
his standard second standard of palliative care is followed which says that based upon identified
issues and needs a care plan is developed. But this standard was not adhered because
introduction of community care provision was done at later stage and that too on weekly basis
(Grindrod, 2021). Due to this delayed palliative care delay was done in continuous monitoring of
Falls Risk Assessment, Braden Pressure Risk Assessment, Pain Assessment, NOK contact
details, and Advanced Health Care Directive was done. Assessment of these factors could have
been done at earlier stages as well that could have helped in preventing deteriorating physical
health and mobility of Tylor (Boyle & et. al. 2020). Remaining all the other standards were
adhered but delay in this palliative care provision was done.
NSQHS Standards
This can be supported with the help of NSQHS Standards that helps in provision of
nationally consistent statement of care that can be expected from an organization or palliative
care givers. As per these standards there are 8 major standards that are required to be adhered by
palliative care givers while providing care to patient. Most of the standards of this NHQHS
standards were adhered by community palliative service providers (Ossenberg, Mitchell &
Henderson, 2020). First standard is clinical governance standard. As per this standard palliative
care givers of Tylor are responsible for providing high quality of service and ensure that their
care provision is centred around Tylor so that improvement within his physically deteriorating

health can be brought. This was done by doing continuous fall assessment, pain assessment,
pressure assessment etc. second standard is partnering with consumer standards (Australia 2018).
This standard was not adhered because partnership with required organizations for providing and
delivering high quality care to Tylor was not done. Third standard was preventing and
controlling infection standards. This standard was adhered by healthcare organization and by
palliative care givers. Continuous assessment of his health, needs was done and monitored which
further helped in ensuring that prevention from infections were done. Next standard was
medication safety standard. This standard was also adhered by palliative care team was done.
Medical Officer from Palliative Care Community Services regularly monitored and updated
Tylor's medications. One of the main NSQHS standard that was required to adhered while
providing high quality care to Tylor was adhering 6th NSQHS standard that says that
communication of safety standards is important to be done for ensuing that high quality care is
provided to patient (Hamilton, 2019). For adhering this standard friends and family members of
Tylor were required to visit him. During that time he was asked to communicate in short bursts.
But however this standard was not meet in an appropriate manner and in required manner
because communication between healthcare professionals, care providers, and patient was not
appropriate and was not focused upon in an effective manner.
NMBA Standards
When community palliative care services were provided to Tylor different kinds of
assessments were conducted and monitored for evaluating current condition of Tylor. His fall
assessment and its risk were done so that required assessment of his fall risk can be done and
preventive measures can be taken (Sharkey & et. al. 2018). Other than this many other kinds of
assessment were also done such as: Braden Pressure Risk Assessment, Pain Assessment, NOK
contact details, and Advanced Health Care Directive etc. This fulfilment of requirement helped
in adhering one of the main NMBA standard that was comprehensive conductions of assessment
(Jensen, 2020). But adhering of this standard further required community palliative care
providers to use complete SAS tool and it was done in an appropriate manner by the community
palliative care providers. Adhering this standard further helped in fulfilling other NMBA
standards such as : development of plan for nursing practice, maintenance of capability of
practice, provision of safe, appropriate and quality nursing practice.

Drawbacks of chosen clinical practice guidelines
Analysis on the basis of above standards and guidelines it was identified that there are
various kinds of drawbacks in current chosen clinical practice guidelines. First and the foremost
drawback was late introduction of community palliative care for Tylor. Due to this his health was
deteriorating continuously. Another drawback was poor communication between patient,
healthcare professionals and palliative care team. Patient communicated only with his family
members that too in short burst. Not only this, patient as well has his family members were not
provided with any kind of health educated related to his deteriorating physical health condition
and mobility. Due to this, his wife was not able to accept his condition and did not further
educate about his condition to his children as well. It was one of the main drawback of palliative
care team because effective communication is base of provision of care to every individual.
Many times due to this, quality and effectiveness of care and services provided to individual or
patient is also hampered. Due to lack of effective communication and coordination among team
members, individual and family members, overall health of Tylor was deteriorating constantly.
and at last he was admitted to terminal Palliative Care Phase but even in this phase he was only
able to remain stable and still of a day and took his last breath. These was only because of non
adherence of all the standards associated clinical practice guidelines
CONCLUSION
From the above essay it has been summarized that there are various kinds of clinical
practice guidelines that can be adhered by health care professionals/ palliative care providers etc.
for providing high quality care to patients. But identification of appropriate standard applicable is
important as it further helps in identifying appropriate standards of care that are required to be
adhered while developing care plan for a patient so that overall condition of patient can be
improved and his quality of life can also be improved.

REFERENCES
Books and journals
Australia, P. C. (2018). National palliative care standards. Canberra: Palliative Care Australia.
Boyle, F. M., & et. al. (2020). Clinical practice guidelines for perinatal bereavement care—an
overview. Women and birth, 33(2), 107-110.
Grindrod, A. (2021). Dying with disability: a disability and palliative care intersectoral
partnership framework. Research and Practice in Intellectual and Developmental
Disabilities, 1-14.
Hamilton, S. (2019). The new NSQHS standards: One day surgery unit's accreditation
experience. Day Surgery Australia, 18(2), 16-18.
Harden, K., & et. al. (2017). Palliative Care: Improving nursing knowledge, attitudes, and
behaviors. Clinical journal of oncology nursing, 21(5).
Jensen, F. (2020). Partnering with consumers through NSQHS standards. Journal of Health
Information and Libraries Australasia, 1(1), 18-19.
Ossenberg, C., Mitchell, M., & Henderson, A. (2020). Adoption of new practice standards in
nursing: revalidation of a tool to measure performance using the Australian registered
nurse standards for practice. Collegian, 27(4), 352-360.
Sharkey, L., & et. al. (2018). National palliative care capacities around the world: results from
the World Health Organization Noncommunicable Disease Country Capacity
Survey. Palliative medicine, 32(1), 106-113.
Smets, T., & et. al. (2018). The palliative care knowledge of nursing home staff: The EU FP7
PACE cross-sectional survey in 322 nursing homes in six European countries. Palliative
medicine, 32(9), 1487-1497.
Watts, G. F., & et. al. (2021). Essentials of a new clinical practice guidance on familial
hypercholesterolaemia for physicians. Internal medicine journal, 51(5), 769-779.
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