Joint Commission Case Study

The Joint Commission on Accreditation of Healthcare Organization (JCAHO) National Quality Safety goals stresses the standard of palliative care provided to patients and families using an interdisciplinary approach. JACHO added pain assessment and symptom management standards making pain the fifth vital sign in an effort to improve the standards of care. The Joint Commission has encouraged all staff to seek education, experience and certification in palliative care. In addition the Joint Commission states that the NCP Clinical Practice Guidelines for Quality Palliative Care originated from evidence based national guidelines which are used to deliver care including physical and psychological interventions, focus on imminent death, taking into

There is a correlation between health care members providing information in a timely manner to patients who need to make decisions about their care and treatment and the quality of care patients receive. Lack of care resulted from physicians being reluctant to refer patients to palliative care. Due to a lack of honest open discussions regarding diagnosis, prognosis and treatment options patient’s suffering was prolonged. Since palliative care focuses on improving symptoms, dignity and quality-of-life it is important that sufficient attention is placed on the complex needs of individuals. The delivery of palliative care has become challenging for nurses. Nurses ought to use a holistic approach to explore any problems that reduce patient’s quality of

Despite her disease progression nine months status- post surgery and three months after chemotherapy the treating oncology team was reluctant to discuss the risk/benefit aspect of chemotherapy and did not consider the option of palliative care in the face of progressive ascites and pleural effusion. Despite her continued decline the palliative care team offered her second-line of aggressive chemotherapy. This makes one wonder is this just bad medicine or is it seriously unethical? A wide range of medical and ethical issues arose in the provision of palliative care for this patient. This exemplified the need for patient’s autonomy, beneficence versus non-maleficence and truth telling. The nurse faced a barrier due to the physician hierarchical working style. Collaborating using a multi-disciplinary approach and communicating effectively in explaining the disease process could have better manage her symptoms and improve the quality of her remaining life. It is important that early detection and treatment options are discussed by the physicians in an honest and open manner. As patients performance status decline healthcare members should provide informed decisions regarding diagnosis, prognosis and