Clinical Practice Guidelines
The following documents have been developed by the Gippsland Region Clinical Practice Group to assist health professionals and palliative care service providers develop their own policies and procedures around palliative care.
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The Advance Care Planning Guidelines support clinical staff to “have the conversation” with clients and caregivers about end of life decision making, engage clients and their families in decisions about their care and help them to undertake advance care planning.
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Breathlessness Guidelines and Flowchart is used to assist in assessment and management of difficult or uncomfortable breathing.
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The Clinical Care Guidelines were developed by Banksia Palliative Care and modified for use in Gippsland.
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The Clinical Supervision and Support Guideline describes clinical supervision options and provides a guide for organisations to support staff and volunteers appropriate to the individual and their scope of practice to access supervision, should they choose to do so.
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When an imminently dying patient expresses a wish to die at home, their request should not be simply viewed as impractical or impossible. Rather, a realistic evaluation of the feasibility of different options should be undertaken.
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Drug Compatibility in Subcutaneous Infusions Chart is a printable colour pictorial chart with indicators of drug compatibility.
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The Management and deactivation of implantable cardioverter defibrillators at end of life guideline provides best practice guidelines for the deactivation of ICDs in hospital and community settings.
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The aim of this guideline is to provide a framework for managing narcosis in patients having opioid analgesia (oral or parenteral) for palliative care symptom management.
This guideline is applicable to all clinical staff responsible for pain assessment and management of patients receiving palliative care in the inpatient setting. It does not address recognition and response to narcosis in the patient’s home environment.
This guideline is not applicable to patients in the terminal phase.
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This guideline aims to provide an overview to support health professionals in managing the process when a patient with Motor Neurone Disease (MND), who is non-invasive ventilation (NIV)-dependent, expresses the desire to discontinue/withdraw NIV. It provides guidance on support for the patient, their family, and the support required by the healthcare team in an inpatient setting, in collaboration with specialist palliative care, in Gippsland.
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The Opioid Conversion Guidelines outline Equianalgesic dose conversions, which are necessary when changing opioid drug therapy in the clinical setting.
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In patients with oxygen saturation at rest of ≤ 90%, a therapeutic trial of oxygen therapy may be reasonable but continued use can only be justified if there is therapeutic benefit.
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Anticipatory prescribing is designed to enable prompt symptom relief at whatever time the client develops distressing symptoms.
Click here to download the Palliative Care Anticipatory Prescribing Guidelines.
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A palliative care emergency is a sudden and life-threatening clinical change in a patient with a life-limiting illness. It requires timely identification, rapid assessment and prompt management to ensure, where possible, rapid reversal of symptoms to promote preservation of quality of life.
Click here to download the Palliative Care Emergencies guidelines.
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The Palliative Care Triage and Transfer form is an electronic referral form template.
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GP referral to community palliative care services is used to inform clinical practice, policies and procedures in health services.
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The Palliative Sedation guideline is to guide the use of continuous palliative sedation therapy in clients undergoing end of life care.
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The 2 part psychosocial screening in palliative care setting and bereavement support in the palliative care setting guideline provides a framework to support generalist clinicians/services, across settings, to include screening for psychosocial distress as a part of palliative care assessment and provides support to staff in routine bereavement care, and to identify triggers for consideration of specialist bereavement care when necessary.
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This Rapid admission for imminently dying patients from the community palliative care to inpatient setting flowchart guides the process for an imminently dying registered community palliative care patient in need of direct admission to hospital.
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The Recommendations for the Care of Patients with Malignant Fungating Wounds document supports best practice among nurses who manage such wounds, based on current literature and experiences.
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The Self care and wellbeing in the palliative care and end of life setting guidelines provide information on self-care options as a part of clinician wellbeing when working in a palliative care environment.
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The Symptom Control Algorithm is a companion document to the Care Plan for the Dying Person. It is based on the PICD algorithm and updated with the most recent evidence from the therapeutic guidelines and palliative care formulary.
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The Verification and Certification of Death outlines the requirement that all patients within Gippsland will have a death certificate signed by a qualified Medical Practitioner within 48 hours of the death, unless they are required to report the death to the Coroner.
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GRPCC CPG Guideline Disclaimer: The intent of clinical guidelines endorsed and made available by the Clinical Practice Group of the GRPCC is to assist health services and clinical staff across the Gippsland region to facilitate evidence based practice in palliative care.
Clinical guidelines are intended to provide general advice to the medical, nursing, and allied health staff working with clients who have life limiting illness. They should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient or organisation.
Whilst the GRPCC endeavours to ensure these clinical guidelines are accurate at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material that may have become available after the issued or reviewed date.
Organisations and health care professionals should ensure that in using the GRPCC guidelines that they are complementary to their current organisational governance structures, and individual clinicians scope of practice.