Hospice and Palliative Care

Author(s):
Doris Neumeyer, RN, BSN Administrative Nurse Clinician

William Beaumont Hospital-Troy
Troy, MI

Published:
October 3, 2014

Abstract

Although hospice care has been practiced for numerous years, recently there have been more published data available that specifically address infection prevention for the hospice or palliative patient population. Infection prevention for this unique set of patients requires a slightly different approach because of the different focus and objectives of this type of care. However, it is important to maintain basic infection prevention practices that pertain to all types of patient care, such as surveillance activities, prevention practices, Standard Precautions, sharps safety, safe handling of biohazardous materials, appropriate disposal of all waste (biohazardous, sharps, and regular waste), and healthcare personnel safety.

The concept of hospice care has been increasingly extended to patients who are not imminently terminal but who have a life-limiting disease (palliative care). Both types of care are provided in a variety of settings, including the patient's home, acute care facilities, and various other types of healthcare facilities across the continuum of care, as well as nonconventional settings such as jails and prisons. Further, the patient may move between these types of settings for care, which requires clear and effective communication between the different caregivers and healthcare personnel during the handoffs. This will ensure that the plan of care the patient desires is maintained.

Although the definitions of "hospice" and "palliative care" may differ, the intent is clearly the same: plan and provide care that supports the patient's goals, desires, and needs while managing the patient's pain and other symptoms as they progress through their disease process toward the end of life. It must be recognized in the planning of care that the patient is not going to recover from the major underlying illness. This differs from traditional medical care, in which the goal is recovery from the afflicting illness or the achievement of optimal levels of function. Infection prevention practices may need to be adapted so that the patient's requests, needs, and dignity are maintained and incorporated as safely as possible into the patient's plan of care.