Principles of practice – Domain 1

This domain includes the underpinning principles and philosophy of a palliative care approach and incorporates elements essential to developing and improving end-of-life and palliative care service provision at an individual and service level. 

1.1 Models of contemporary care

The following learning items relate to National Palliative Care Standard 5 and 7.

The learning items below are relevant to the entirety of 1.1 Models of care.
Learning item Resource
Foundation
1.1.1. Person, carer and family-centred care
1.1.2. Models of contemporary end-of-life and palliative care 
  • adult
  • paediatric (perinatal – adolescent)
Paediatric
1.1.3. Models for delivery of care for: 
  • Aboriginal people
  • people with a disability
  • culturally and linguistically diverse people
  • condition specific groups
  • marginalised groups including people experiencing homelessness
  • prisoners
  • children under the care of the Chief Executive Officer of the Department of Communities

Aboriginal people

People with a disability Culturally and linguistically diverse people
1.1.4. Integrative care and care partnerships
  • Voluntary Assisted Dying: Essential information for health professionals
    This eLearning program takes all healthcare workers through the key components of the Act to assist them in understanding their roles, rights and responsibilities in the voluntary assisted dying process. It includes an overview of the voluntary assisted dying process, with additional information for medical practitioners, nurse practitioners and pharmacists.

    This eLearning package has been adapted with permission from a resource of the WA Country Health Service.
1.1.5. Delivering end-of-life and palliative care in different settings: 
  • preferred place of care
  • inpatient care
  • specialist palliative care units
  • emergency departments
  • acute consultative care services
  • community/primary care
  • residential aged care
  • respite care facilities and in-home respite for children
  • older adult mental health
  • disability care
  • mental health
  • correctional facilities

Residential aged care

Emergency departments Community/primary care
1.1.6. Rural and remote care
1.1.7. Different modes of end-of-life palliative care delivery
Consolidation
1.1.8. Providing end-of-life and palliative care at the right time, in the right place, with the right team
1.1.9. Embedding the end-of-life continuum and models of care into practic 
1.1.10. Integrative care and care partnerships:
  • groups’ theories
  • team members’ roles and contributions.
  • shared care
1.1.11. Intergenerational concepts of end-of-life and palliative care
1.1.12. Transitioning individuals from paediatric services to adult end-of-life and palliative care services
Extension
1.1.13. Partnerships with others (consumers, carers, other health professionals, organisations/services and communities) to improve end-of-life and palliative care
1.1.14. Formal strategies to support end-of-life and palliative care through:
  • capacity building
  • care in the preferred setting 
  • innovation and evidence-based practice
1.2 Professional responsibilities

The following learning items relate to National Palliative Care Standard 5 and 9.

Learning item Resource

Foundation
1.2.1. Respecting the person, their family and/or carers and colleagues

1.2.2. Working with others: 
  • working within and with other teams
  • professional accountability and boundaries
  • identifying own limitations
1.2.3. Informing professional practice through: 
  • research and evidence-based practice
  • legal and legislative requirements
  • privacy and confidentiality
  • use of social media
  • public relations

1.2.4. Self-care and work-life balance

Consolidation

1.2.5. Facilitating personal autonomy
1.2.6. Facilitating personal and family resilience
1.2.7. Collegiate practice
1.2.8. Respecting and promoting the expertise and contribution of colleagues, teams and other disciplines
1.2.9. Relationship building
1.2.10. Building clinical capacity
1.2.11. Fostering professional development
1.2.12. Professional and team boundaries

Extension

1.2.13. Building cultures of professional practice through:

  • development of emerging professional leaders
  • planned formal training in end-of-life and palliative care
  • structured mentoring programs
  • sustaining teams (e.g. values, goals)
  • sustaining strategies for healthy teams (e.g. values, goals, professional supervision, team building)

1.3 Communication

The following learning items relate to National Palliative Care Standard 2 and 5.

The learning items below are relevant to the entirety of 1.3 Communication.

Learning item Resource
Foundation
1.3.1. Developing communication skills in end-of-life and palliative care through training in: 
  • effective communication
  • cultural and linguistically diverse needs
  • needs of Aboriginal people
  • use of interpreters and other language services and supports
  • verbal and written
  • use of telehealth
  • in challenging situations with, individuals, children, siblings, families and/or carers and colleagues
  • developmental and age-specific communication
1.3.2. Communicating during care transitions 
  • Goals of Patient Care process
  • with other care providers/settings supporting care
  • difficult conversations
  • curative to palliative care
  • increasing decline to terminal phase
  • care of the dying person
  • loss grief and bereavement

1.3.3. Clinical handover: 

  • timely, relevant and structured handover
Consolidation  
1.3.4. Facilitating individual, family/carer(s) communication in: 
  • advance care planning conversations 
  • initiating and reviewing Goals of Patient Care
  • key transitions in care 
  • family meetings • family conferences 
  • intra and interfacility transfer 
  • death and bereavement reviews 
  • use of interpreters and other language services 
  • breaking bad news and difficult conversations 
  • discussions regarding prognosis
  • times of crisis and conflict
1.3.5. Facilitating team communication:
  • complex case and death review 
  • team meetings 
  • interdisciplinary and inter-agency meetings
  • clinical handover
1.3.6. Transitioning from paediatric to adult services
 
Extension  
1.3.7. Developing advanced team communication skills
1.3.8. Anticipating and managing conflict:
  • between teams, the person and their family/carer(s)
  • within teams
  • with other services and stakeholders
  • dispute and conflict resolution
  • complaints management
1.3.9. Instituting formal processes for effective communication in practice:
  • reflective practice and experiential learning
  • clinical mentoring programs
  • clinical supervision
  • critical thinking and problem solving
  • clinical handover
  • Goals of Patient Care
  • involvement of the child in Goals of Patient Care conversations
  • formal communication processes across care settings

1.4 Ethics and decision-making

The following learning items relate to National Palliative Care Standard 2 and 4.

Learning item Resources
Foundation
1.4.1. Own beliefs and values and how these affect decision-making and influence practice
1.4.2. Ethical and decision-making frameworks
1.4.3. Ethical issues in end-of-life and palliative care:
  • primacy of the person
  • personal autonomy
  • benefits and burdens of treatment in determining Goals of Patient Care
  • non-beneficial treatments
  • integrative care
  • principle of double effect
  • withdrawing/withholding treatment
  • withdrawal of artificial fluids and nutrition
  • transition from curative to non-curative care including end-of-life care
  • Voluntary Assisted Dying (VAD)

1.4.4. Legislation related to end-of-life and palliative care 

The learning items below are relevant to the entirety of 1.4 Ethics and decision making


Consolidation
1.4.5. Using ethical principles and frameworks in practice
1.4.6. Participating in ethical decision-making in end-of-life and palliative care:
  • with the person and family/carer(s)
  • with children
  • advocacy for the person
  • capacity
  • mature minors
  • informed consent
  • within and between health care teams
  • clinical ethics committees.
1.4.7. Interpreting and applying legislation in end-of-life and palliative care
Extension
1.4.8. Using ethical decision-making frameworks in service delivery
1.4.9. Supporting establishment and use of clinical ethics committees Leading ethical decision-making processes at service level:
  • supporting clinical governance
  • benefits versus burdens of treatment
  • non-beneficial treatments
  • economic rationalism in service provision conflict resolution in decision-making with the person, families/carer(s) and teams
1.4.10. Risk management including media interest and public relations
 
Last reviewed: 14-02-2022
Produced by

End-of-Life Care Program