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Recommendations About Training in Palliative Care in Nursing Degree of the Spanish Palliative Care Nurses Association

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Recommendations About Training in Palliative Care in Nursing Degree of the Spanish Palliative Care Nurses Association Recommendations about training in palliative care in nursing degree of the Spanish Palliative Care Nurses Association Supported by: Recommendations about training in palliative care in nursing degree of the Spanish Palliative Care Nurses Association © Copyright October, 2019. All rights reserved. The material may not be reproduced or distributed, in whole or in part, without the prior written permission. However, reproduction and distribution, in whole or in part, by non-profit, research or educational institutions for their own use is permitted if proper credit is given, with full citation, and copyright is acknowledged. Any other reproduction or distribution, in whatever form and by whatever media, is expressly prohibited without the prior written consent. ISBN: 978-84-09-14421-1 Depósito Legal: M-30847-2019 © Tel. +34 607 82 53 44 / Fax. +91 547 05 70 C/ Irún, 21. 28008 Madrid. SUMMARY AUTHORS INDEX 5 PROLOGUE 7 I. JUSTIFICATION 9 II. NURSING COMPETENCES IN PALLIATIVE CARE 17 Objectives Competences to acquire III. CONTENTS PROPOSAL FOR THE COURSE OF PALLIATIVE CARE 23 IV. PROFESSOR’S PROFILE 35 EPILOGUE 39 Recommendations about training in palliative care in nursing degree of the Spanish Palliative Care Nurses Association 3 AUTHORS INDEX Authors Isidro García Salvador Coordinator. Hospital Universitario Dr. Peset. Valencia Pilar Vallés Martínez Palliative Care Unit. Área de Gestión Sanitaria del Campo Gibraltar. Algeciras Lourdes Guanter Peris Instituto Catalán de Oncología. Barcelona Luis Utor Ponce Homecare Support Team. Ceuta María Paulina Pérez Yuste Hospital Los Montalvos. Complejo Hospitalario. Salamanca Natalia López-Casero Beltrán Palliative Care Unit. Hospital Mancha Centro Alcázar de San Juan. Ciudad Real Vicente Robles Alonso Homecare Support Team. Área de salud de Plasencia. Servicio Extremeño de Salud. Centro Universitario de Plasencia. Universidad de Extremadura Pilar Campos Monfort Palliative Care Hospital Laguna. Madrid Elena Chover Sierra Hospital General Universitario de Valencia. Part-time professor. Facultat d’Infermeria i Podologia. Universitat de Valencia Teresa Plaza Escribano Our Lady's Hospice & Care Services-Harold´s Cross. Dublin, Ireland Francisca Rosa Jiménez López Universidad de Almería English translation has been made by: Elena Chover Sierra Pilar Chover Sierra Recommendations about training in palliative care in nursing degree of the Spanish Palliative Care Nurses Association 5 External reviewers María Paz Miguel Vázquez Hospital universitario de Burgos María Ángeles Martín Homecare Support Team Mérida. Servicio Extremeño de Salud Encarnación Chisbert Alapont Hospital Universitario Dr. Peset. Valencia Marisa de la Rica Escuin Instituto de Investigación Sanitaria de Aragón. Universidad de Zaragoza Ana María Tordable Ramírez Gerencia Asistencial de Atención Primaria del Servicio Madrileño de Salud María José Cabañero Martínez Universidad de Alicante Ana Carvajal Valcárcel Universidad de Navarra Miguel Duarte Rodríguez Enfermero Gestor de Casos. Distrito de Atención Primaria de Sevilla Julia Frasquet Morant Palliative Care Unit. Hospital Universitario Dr. Negrín. Las Palmas de Gran Canaria Ángel López Triguero Servicio de Hospitalización a Domicilio y Cuidados Paliativos del Hospital do Salnés (Vilagarcía de Arousa), EOXI de Pontevedra e O Salnés María Arantzamendi Solabarrieta Universidad de Navarra. Instituto Cultura y Sociedad. Programa ATLANTES: Dignidad humana, enfermedad avanzada y cuidados paliativos. Pamplona Eva Abad Corpa DG Asistencia Sanitaria, Servicio Murciano de Salud / Facultad de Enfermería, Universidad de Murcia Amor Aradilla Herrero Profesora Titular Enfermería. Profesora de la asignatura Enfermería en Cuidados Paliativos. Escuela Universitaria de Enfermería Gimbernat (adscrita a la UAB) Cristina Monforte Royo Directora Departament d’Infermeria. Vicedecana Facultat de Medicina i Ciències de la Salut. Universitat Internacional de Catalunya 6 Recommendations about training in palliative care in nursing degree of the Spanish Palliative Care Nurses Association PROLOGUE Isidro García Salvador AECPAL’s President This document is the outcome of the work done by the training group of the Spanish in Palliative Care Nurses Association (AECPAL). The objective of this project, as a result on the consensus of experts in palliative care as a scientific society, has been to develop a document that can guide future nursing professionals in the training given in universities. From AECPAL, we consider as necessary the acquisition by nurses of the basic skills in palliative care in their university education. This training is highly recommended as an independent compulsory subject to be taught by teachers who have previously acquired these competences. Based on the existing information in the scientific literature, in our professional experience and in a deep reflection, in the following document we have elaborated this proposal both of the competences to be acquired by the students, and of the contents to be developed in this formation. Finally, we offer some notes on the profile of the teaching staff in palliative care. I would like to thank the members of the training group for their dedication and perseverance in this work. I also extend mi appreciation to external reviewers who have contributed with very interesting reflections and suggestions, which have helped us to enrich the document that we present below. Recommendations about training in palliative care in nursing degree of the Spanish Palliative Care Nurses Association 7 Chapter I Justification Isidro García Salvador, Pilar Vallés Martínez Recommendations about training in palliative care in nursing degree of the Spanish Palliative Care Nurses Association 9 Chapter I 2. Justification Caring people with advanced disease and in end-of-life stages, as well as the attention to the needs of their families continues to pose considerable challenges, mainly, the poor training in palliative care of health professionals, the insufficient communication skills and the still mistaken consideration of death as a therapeutic failure1-3. The nursing contribution from a biopsychosocial and spiritual approach that guarantees a compre- hensive care of the patient and their family/caregivers has little visibility in the healthcare setting. However, we must not forget that nurses have a range of knowledge appropriate to their discipline, a methodological strategy that supports the planning of their interventions, a deontological code and a legal framework that guarantees their actions4, 5. Given the increasing complexity of the care required by people with advanced disease and / or end of life, along with the variability of professionals involved in the care process, it is necessary to clarify the training and professional nursing role in palliative care setting6. The Spanish Nursing Association in Palliative Care (AECPAL), since its inception in 2005, promulgates the need to develop its own doc- trinal body and a specific training curriculum in palliative care in Nursing. It also defends as a guiding principle that the competences for professional practice are the result of theoretical training and clinical practice; consequently, it is stablished constant feedback between theory tuition (basic, inter- mediate and / or advanced level) and palliative care, as well as the progress of knowledge based on practice and the application of those skills in such practice. The current scenario in which palliative care is developed in Spain faces a lack of management of specific training of health professionals, so that academic regulation does not go hand in hand the social and health requirements2. Analyses carried out by different organisms show that Spain is one of the most ageing countries on the planet, and this will cause an increase chronicity, multimorbidity and disability in the population7-9. Three out of four deaths in the Spanish state are caused by the progression of one or more chronic health problems10. The provision of palliative care takes place at different levels in which diverse types of resources are included, to which patients do not always have access11. In fact, somes studies show that one out of every three patients admitted to acute care hospitals have palliative needs12-14. But only those who meet certain criteria of complexity could be treated and cared for by expert professionals who de- velop their activity on specific resources of palliative care. In these circumstances, it is common for any nurse, in the course of their professional activity to deal with people in end-of-life processes, in several healthcare settings. This is the reason why they should have at least a level of basic training in care palliative, acquired preferably during their university education. The experience acquired during the evolution of Palliative Care demonstrates that the education process in this field must begin during the degree and continue during the postgraduate programs for those nurses who wish to be specialized in the discipline. Furthermore, there must be the possibility of continuous ed- ucation to maintain updated knowledge and skills and ensure that professional performance is based on scientific evidence and adheres to the quality standards that patients with palliative needs deserve15. However, in Spain, it is not contemplated in nursing degree training that basic skills in palliative care are acquired as part of their basic curriculum15. This fact means that in the future, nursing professionals can not guarantee the right of any
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