The Palliative Care Unit is embedded in the Department of Anaesthesia and Critical Care Medicine and is in close cooperation with the Division for Hematology and Oncology. The palliative care team was founded in 2005 by the head of the department for Anaesthesia and Critical Care Medicine On 2004, a complete new palliative care ward with 14 beds was inaugurated. The official opening was celebrated on July 2004.
The Department of Hematology and Oncology consists of three inpatient wards covering 38 beds and two outpatient divisions. The department head is Professor Wolfgang Eisterer, hemato-oncologist who received his training at the Medical University of Innsbruck. There are eight oncologists, including the head of the division. On the wards four oncologists, 18 nurses and three interns are in charge for the oncologic patients. The outpatient clinic is led by three oncologists. In 2018, the number of inpatients was 1.766; the outpatient clinic including the day care clinic had 20.138 visits. In 2018, 333 patients were admitted on the palliative care ward.
In addition, the palliative and support team consults and visits all palliative patients who are admitted to other wards in the hospital. In 2018, 280 patients were seen by the consulting team on other wards in the hospital. Additionally, the palliative and support team visits patients at home, and networks with home care services and GPs.
In 2018, 309 patients were supported by the mobile team. There were 1041 patient visits, resulting in 17500 kilometers driven.
Areas of specialisation
13.1. Please describe palliative cancer care teaching activities to:
13.1.1 Medical and nursing students
Medical students are present during their vacation, doing summer electives in the hospital. All students will receive a crash-course in general pain management as well as a lecture about symptom control in palliative care patients during their stay by members of the palliative care team.
Nursing students will learn basic aspects of palliative care during their training.
13.1.2. House staff
Every week, there is a lecture for all staff members, including doctors and nurses, about various topics in medicine. These lectures are organized by the head of the hematology-oncology division and include frequently topics about palliative care (e.g., management of pain, dyspnea, bowel obstruction).
Interns have to give a lecture to their colleagues once a week. The range of topics also includes palliative care issues (pain, symptom control). When an intern gives a talk about a palliative care issue, he is supervised by a member of the palliative care team.
Interns are asked to join the consultant of the mobile palliative care team to achieve competence in pain- and symptom management.
13.1.3. Oncology trainees
Oncology trainees are invited to join pain and symptom control consulting with the palliative care team. In addition, they give talks about symptom control issues regularly.
Our team organizes visits to primary schools, where kids are taught about issues like hospice care and palliative care.
13.2. Please describe any teaching publications:
Extravasation emergencies: state-of-the-art management and progress in clinical research. Pluschnig U, Haslik W, Bartsch R, Mader RM. Memo 2016;9:226-230. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, Steger GG, Zielinski CC, Mader RM. Support Care Cancer 2015;23:1741-8.
Palliative and supportive care
The aim of our team is to relieve physical symptoms as quick and efficiently as possible. Pain assessment is present in the whole hospital, using a visual analogue score, evaluation is implemented in the patients chart record. The PC team also monitors for other symptoms such as dyspnea, nausea/emesis, constipation and other disease related symptoms. At the moment, guidelines regarding other palliative symptoms are implemented in the hospital, monitored by the PC physicians.
A "pain-team", consisting of anesthesiologists, doctors for physiotherapy, oncologists and palliative care physicians will discuss and try to solve complex pain problems in an interdisciplinary manner. When an invasive analgesic procedure is needed, anesthesiologists are available.
Almost all members of the palliative care team have special training in palliative care. Their credentials are listed below (Table 1).
The palliative care team consists of:
- Three medical doctors, two of them working full time, one part-time.
- 19 nurses, 17,5 working on the ward, four involved in the support- and mobile team. Three nurses are working on the ward and in the support- and mobile team.
- One psychologist, 20 hours
- A social worker 20 hours
- A nutritionist is involved in monitoring patients' needs concerning nutritional supplements, enteral and parenteral nutrition
- A volunteer team, consisting of 10 members, all of whom participated in a basic course for volunteers working with palliative care patients.
In addition, our hospital offers physiotherapists and occupational therapists to all patients.
If patients wish, we can also offer some services related to complementary and alternative medicine, as most team members have additional training in acupuncture, homeopathy, aromatherapy and relaxation techniques.