Paediatric Palliative Care

This subject has the following teaching availabilities in 2013:

Intensive Delivery

In addition to face-to-face teaching time of 40 hours, students should expect to undertake a minimum of 80 hours research, reading, writing and general study to complete this subject successfully.

For the purposes of considering request for Reasonable Adjustments under the Disability Standards for Education (Cwth 2005), and Student Support and Engagement Policy, academic requirements for this subject are articulated in the Subject Overview, Learning Outcomes, Assessment and Generic Skills sections of this entry.

It is University policy to take all reasonable steps to minimise the impact of disability upon academic study, and reasonable adjustments will be made to enhance a student's participation in the University's programs. Students who feel their disability may impact on meeting the requirements of this subject are encouraged to discuss this matter with a Faculty Student Adviser and Student Equity and Disability Support: http://services.unimelb.edu.au/disability

The subject will enable health professionals to develop and consolidate skills when caring for children with life limiting conditions. The course will explore palliative approaches to care, the diversity of diagnostic groups, symptom management, psychosocial and ethical issues for palliative children and their families.
Throughout the course work, students will have the opportunity to participate in a variety of teaching methods including; workshops, seminars, tutorials and role playing with much emphasis placed on adult /group learning and sharing.

This subject will consist of 5 teaching modules;

1. Evidence Based Palliative Care
   Incorporating: Basics of quantitative and qualitative research, ethical issues, evaluation, quality activities, implementing research into practice and dissemination strategies (eg. presentations, publications etc).
2. Illnesses Encountered in Paediatric Palliative Care
   Incorporating: General principles of paediatric palliative care. Malignant conditions, neurodegenerative conditions, chromosomal disorders and congenital anomalies
   o What is paediatric palliative care?
   o Disease groups – Malignant Vs Non-Maligant
   o Differences between Paediatric and adult palliative care
   o Best practices
   o Transition to paediatric palliative care
   o Myths
   o Places of care
3. Symptom Management in Paediatric Palliative Care
   Incorporating: assessment and management of children of varying ages with a range of diagnoses (including children with disabilities).
   o Pain Management
   o Respiratory Symptoms
   o Neurological symptoms
   o Fatigue
   o Haematological
   o Dying Process
4. Psychosocial and Spiritual Aspects
   Incorporating: supporting children with life-limiting conditions, their siblings and parents and self-care for health professionals. Including bereavement care.
   o Supporting the dying child,
   o School
   o Religious and Cultural Consideration
   o Communication
   o Grief – parental, sibling, grandparents
   o School
   o Funerals
   o Creativity
   o Sudden Death
   o Self Care
5. Ethics
   Incorporating: decision-making with children and/or their parents. Cultural influences.
   o Autonomy
   o Competence
   o Decision Making
   o Withdrawal of Treatment
   o NFR orders
   o Conflict
   o Euthanasia
   o Hydration & Nutrition
   o Medical Ethics in Different Cultures

Evidence Based Palliative Care

• Explore the principles of evidence based practice
• Identify symptoms often experienced by patients during the palliative phase of an illness
• Explore current evidence based strategies for complex symptom management

Illnesses Encountered in Paediatric Palliative Care

• Demonstrate an understanding of the epidemiology of paediatric palliative care.
• Recognise the difference between adult palliative care versus paediatric
• To understand the current definition and best practices in paediatric palliative care.

Symptom Management in Paediatric Palliative Care

• To increase knowledge and skills in how to recognise and assess pain in children according to age and developmental stage including verbal and non-verbal cues.
• To have an understanding of the therapeutic and complimentary options available for pain and other symptom management for infants, children and teenagers.
• To enhance knowledge and skills in symptom control ( e.g. respiratory, vomiting, seizures)
• To increase awareness of how the symptoms affect the child and family’s functioning.
• Recognise the difference between palliative care and terminal care.
• Develop knowledge & understanding of the terminal phases of palliative care.

Psychosocial and Spiritual Aspects

• Recognise the psychological impact of the illness on the child and family.
  Able to understand & articulate the importance of social, cultural and spiritual needs of palliative children & families.
• To improve communication of health professionals with children with palliative care needs and their families.
• Develop knowledge of current support services available for palliative children and their families.
• Develop knowledge & understanding around the grief process & its impact on the child, parents, siblings, family members, friends & community supports such as school.
• To improve knowledge and awareness of bereavement support in paediatrics
• To understand the importance and impact of paediatric palliative care on self
• Development of personal and team strategies for self care.

Ethics

• Recognise the complexity of paediatric palliative care and the many ethical issues it encompasses.
• To gain an understanding of the legislative frameworks which govern practice and accountability

Assessment 1: Review & Critique a Clinical Issue (50%)
Word limit: 2,000 words.
Due two (2) weeks after completion of the teaching component
· Identify a palliative care clinical issue relevant to their practice and role.
· Review and critique the current literature and evidence base to guide practice relevant to the chosen issue.
· Include a minimum of five recent articles, with a critical discussion of the findings identified within the articles overall.
· The papers should be of varying methodologies and from different journals.

Assessment 2: Self-Directed Clinical Portfolio (50%)
Word limit: 3,000 words.
Due 6 weeks after completion of the teaching component
· Set of self directed clinically focused learning activities assessed by a clinical mentor
Students are required to complete one self directed clinically focused learning activity, in consultation with a clinical mentor. A clinical mentor will be assigned to each student. The portfolio activity should focus on an area of practice in which the student would like to improve their knowledge, skills and confidence. The activity should be a different topic to the one chosen for Assessment component 1 and is to be directly linked to enhancing the student’s capacity to practice at an advanced level.

All students will be provided with course notes which incorporate reading material and assessments.

This subject is not available as a breadth subject.

• Oral and written communication
• Problem Solving
• Application of theory to practice
• Interpretation and analysis
• Teamwork
• Critical Thinking