Palliative performance scale #manly #paradise #motel

#palliative performance scale

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Before We Begin

This module has been created to educate health care providers about the Palliative Performance Scale.

There are a number of questions in this first version of the module to assist Lee Ann Fox RN, BScN, CON(C), CHPCN(C), graduate student University of Victoria, in her research to understand the needs of providers in these area.

This module will take approximately 30 minutes to complete.

Objectives

After completing this module you will be able to:

explain the components of the Palliative Performance Scale (PPS)

apply the PPS to a variety of clinical examples

describe the utility and risks of using a communication tool like the PPS

Palliative Care

The sunflower is the international symbol of hospice care. Hospice is not a place but a philosophy of care and may be more familiar to you as palliative care.

The Canadian Hospice Palliative Care Association defines Hospice Palliative Care as “care that aims to relieve suffering and improve the quality of living and dying.”[1]





The Palliative Performance Scale #vegas #hotels

#palliative performance scale

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The Palliative Performance Scale

The Palliative Performance Scale (PPS) is a valid, reliable functional assessment tool developed by Victoria Hospice that is based on the Karnofsky Performance Scale (KPS ) [3] and is incorporated into the collaborative care plans in the Palliative Care Integration Project that began in Kingston. This tool provides a framework for measuring progressive decline in palliative patients.

In the PPS[4]. physical performance is measured in 10% decremental levels from fully ambulatory and healthy (100%) to death (0%). These levels are further differentiated by five observable parameters:

the degree of ambulation

ability to do activities/extent of disease

ability to do self care

level of consciousness

“Stronger” performance indicators are located on the left, and “softer” ones on the right. In determining the patient’s PPS then, we would first find the level that fits with the patient’s ambulation level. From that we would work across the scale keeping in mind that the leftward indicators have more value than those on the right. We can not choose between levels (e.g. 45%). Simply make your best assessment to determine the PPS.

PPS Stages





Karnofsky Performance Status Scale #banff #springs #hotel

#palliative performance scale

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The Karnofsky Performance Scale Index allows patients to be classified as to their functional impairment. This can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients. The lower the Karnofsky score, the worse the survival for most serious illnesses.

KARNOFSKY PERFORMANCE STATUS SCALE DEFINITIONS RATING (%) CRITERIA

Able to carry on normal activity and to work; no special care needed.

Normal no complaints; no evidence of disease.

Able to carry on normal activity; minor signs or symptoms of disease.

Normal activity with effort; some signs or symptoms of disease.

Unable to work; able to live at home and care for most personal needs; varying amount of assistance needed.

Cares for self; unable to carry on normal activity or to do active work.

Requires occasional assistance, but is able to care for most of his personal needs.

Requires considerable assistance and frequent medical care.

Unable to care for self; requires equivalent of institutional or hospital care; disease may be progressing rapidly.

Disabled; requires special care and assistance.

Severely disabled; hospital admission is indicated although death not imminent.

Very sick; hospital admission necessary; active supportive treatment necessary.

Moribund; fatal processes progressing rapidly.

References:
Crooks, V, Waller S, et al. The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients. J Gerontol. 1991; 46: M139-M144.
de Haan R, Aaronson A, et al. Measuring quality of life in stroke. Stroke. 1993; 24:320- 327.
Hollen PJ, Gralla RJ, et al. Measurement of quality of life in patients with lung cancer in multicenter trials of new therapies. Cancer. 1994; 73: 2087-2098.
O’Toole DM, Golden AM. Evaluating cancer patients for rehabilitation potential. West J Med. 1991; 155:384-387.
Oxford Textbook of Palliative Medicine, Oxford University Press. 1993;109.
Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: Reliability, validity, and guidelines. J Clin Oncology. 1984; 2:187-193.





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Maximum Sturdiness

Our treads are entirely made of wood and are extremely sturdy. They are 44cm* thick on winder and spiral staircases, and 35cm thick on spacesaver staircases.

Resistance to wear

All our staircases are painted with water-based paints, which make them durable, safe and resistant to wear.

Safety and Reliability

Our products are built following the safety standards for domestic environments, with a special focus on the safety of children.

Our Materials are Certified

The wood used to build our staircases has obtained the FSC certification. We source our wood from sustainably managed forests.

Our business hours are: Monday – Friday 8:30 – 13:00 | 14:00 – 17:30. If I can be of assistance, please do not hesitate to contact at 0800 6406066

Maximum Sturdiness

Our treads are entirely made of wood and are extremely sturdy. They are 44cm* thick on winder and spiral staircases, and 35cm thick on spacesaver staircases.

Resistance to wear

All our staircases are painted with water-based paints, which make them durable, safe and resistant to wear.

Safety and Reliability

Our products are built following the safety standards for domestic environments, with a special focus on the safety of children.

Our Materials are Certified

The wood used to build our staircases has obtained the FSC certification. We source our wood from sustainably managed forests.

Our business hours are: Monday – Friday 8:30 – 13:00 | 14:00 – 17:30. If I can be of assistance, please do not hesitate to contact at 0800 6406066

Maximum Sturdiness

Manufactured in pressed steel for manual ladders and entirely in aluminum for electric ladders.

Resistance to wear

The material used makes the loft ladders in the durable time and weather resistant.

Quick installation

All products are fully pre-assembled and designed for quick installation and maximum accessibility

Certification

European rule of law EN 14975:2006 – Formaldehyde emissions Class E1 certified to Standard UNI EN 13986:2005 – Transmittance rule UNI EN ISO 6946:2008 e UNI EN ISO 10211:2008

Our business hours are: Monday – Friday 8:30 – 13:00 | 14:00 – 17:30. If I can be of assistance, please do not hesitate to contact at 0800 6406066

Maximum Sturdiness

Our treads are entirely made of wood and are extremely sturdy. They are 44cm* thick on winder and spiral staircases, and 35cm thick on spacesaver staircases.

Resistance to wear

All our staircases are painted with water-based paints, which make them durable, safe and resistant to wear.

Safety and Reliability

Our products are built following the safety standards for domestic environments, with a special focus on the safety of children.

Our Materials are Certified

The wood used to build our staircases has obtained the FSC certification. We source our wood from sustainably managed forests.

The doors are open: Milano welcomes My Place, Fontanot’s laboratory of ideas in the bustling heart of Porta Nuova, Milan’s up and coming urban area.

When you need to connect two or more floors in an apartment, you’ll always have to make a choice between spiral stairs or a winding staircase. Interior stairs are very important because they can enhance or completely ruin the aesthetic quality of an apartment, whether it is a loft or studio.

As with all things designed by the Cupertino based company, Apple Stores are iconic, and are an expression of the hopes and desires of an entire generation.

Suspended Stairs: The Design that Challenges the Law of Gravity If Newton had lived to view these stairs during his lifetime, he may just have abandoned his theory of gravity entirely.


EPrognosis – Palliative Performance Scale #paradise #motel

#palliative performance scale

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Palliative Performance Scale

  • Population: Outpatients with advanced cancer
  • Outcome: Median Survival in days
  • Scroll to the bottom for more detailed information
  • The Palliative Performance Scale (PPS) has been shown to be both valid and useful for a broad range of palliative care patients: those with advanced cancer diagnoses or life-threatening non-cancer diagnoses in clinics, hospitals, or hospices.
  • The PPS scale 1 was developed in 119 palliative care patients at home (73% with PPS rating between 40-70%) and 213 patients admitted to a hospice unit (83% with PPS rating between 20-50% on admission) in Victoria, British Columbia.
  • Prognostic estimates for outpatients with advanced cancer were externally validated in a study 2 of 1,655 adults from an outpatient Oncology Palliative Care Clinic in Toronto, Ontario, Canada between April 2007 and February 2010 (median age of 65 years, 51% female, 91% of patients had died at time of analysis).
  • Discrimination: This risk calculator indicates modest predictive performance (c-statistic=0.63) using the PPS.
  • Calibration: Calibration was not assessed.
  • Citations:
    • 1) Anderson F, Downing GM, Hill J, Casorso L, Lerch N. Palliative Performance scale (PPS): a new tool. J Pall Care, 12(1): 5-11
    • 2) Jang RW, Caraiscos VB, Swami N, Banerjee S, Mak E, Kaya E, Rodin G, Bryson J, Ridley JZ, Le LW, Zimmermann C. Simple Prognostic Model for patients with advanced cancer based on performance status. J Clin Oncol. 2014; 10(5): 335-341.




The Palliative Performance Scale #what #is #a #hospice #center

#palliative performance scale

#

The Palliative Performance Scale

The Palliative Performance Scale (PPS) is a valid, reliable functional assessment tool developed by Victoria Hospice that is based on the Karnofsky Performance Scale (KPS ) [3] and is incorporated into the collaborative care plans in the Palliative Care Integration Project that began in Kingston. This tool provides a framework for measuring progressive decline in palliative patients.

In the PPS[4]. physical performance is measured in 10% decremental levels from fully ambulatory and healthy (100%) to death (0%). These levels are further differentiated by five observable parameters:

the degree of ambulation

ability to do activities/extent of disease

ability to do self care

level of consciousness

“Stronger” performance indicators are located on the left, and “softer” ones on the right. In determining the patient’s PPS then, we would first find the level that fits with the patient’s ambulation level. From that we would work across the scale keeping in mind that the leftward indicators have more value than those on the right. We can not choose between levels (e.g. 45%). Simply make your best assessment to determine the PPS.

PPS Stages