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Palliative Care Nursing in the Outpatient Setting 

Palliative Care Nursing in the Outpatient Setting
Chapter:
Palliative Care Nursing in the Outpatient Setting
Author(s):

Pamela Stitzlein Davies

, and Kathleen Broglio

DOI:
10.1093/med/9780190862374.003.0052
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date: 26 August 2019

Most healthcare in the United States is provided in ambulatory care clinics. Yet, outside of the arena of oncology, palliative care clinics are rare in the outpatient setting. This is an area of great need, and one that is expected to see significant growth, given the complexities of issues managed by primary clinicians. Palliative care can assist with decisions related to initiating or discontinuing left ventricular assist devices for destination therapy or renal replacement therapy and address the multimorbidity, frailty, and dementia associated with the growing population of elder adults. This chapter addresses the benefits and challenges faced when providing palliative care in the ambulatory care setting. Practical aspects of initiating or expanding an outpatient palliative care program are discussed, as well as unique aspects of providing palliative care to various clinical specialties in the outpatient setting. Additionally, best practices for monitoring opioid and other controlled substances are reviewed, including methods to implement Universal Precautions for screening and monitoring patients receiving these prescriptions.

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