Management of Subcutaneous Infusions in Palliative Care

• Home
• Package Guide
• Learning Modules
  • Introduction:
  • Section 1: The Patient and Family/Carer Experience
  • Section 2: General Equipment
  • Section 3: Selection and Preparation of the Site
  • Section 4: Drugs and Diluents
  • Section 5: Patient and Family/Carer Education
  • Section 6: Patient Assessment and Troubleshooting
• The Guidelines
• References
• Resources
• Printable Documents
• CPCRE Home

A Guide To The Learning Package

Use of subcutaneous infusion devices has become standard practice in palliative care and improves patient comfort by administration of medications at a constant rate to assist in successful control of a variety of symptoms.

Information contained in the learning package is presented to promote a standard approach to clinical care involving a subcutaneous infusion. It is not intended as education in any specific device. It provides base line information to be used to develop knowledge for beginner level practice with subcutaneous infusion devices or revision for the more experienced practitioner.

The package is presented in three different forms – website, DVD, and hard copy – to cater for different learning styles and preferences and because some health professionals will have limited internet access and/or web navigation skills. The package presents introductory information about subcutaneous infusions and devices including recent changes in Australia, and six separate modules, each based on the Centre for Palliative Care Research and Education’s ‘Guidelines for subcutaneous infusion device management in palliative care’.

It is suggested that you work through each of the modules in turn. You should read the information in each module, read or watch given links and complete activities. At the end of each module, a series of questions in the form of a short quiz will be presented to enable you to test your understanding. You should find the answers to these questions by reviewing the content and links and completing all of the activities in each module. The package also requires you to source certain information from your own organisation.

Completion of all modules of the learning package provides base line information for best practice use of subcutaneous infusion devices, allowing for competency development and maintenance. Completion of the self assessment including discussion with a knowledgeable health professional is recommended.

Some Adult Learning Principles for the Educator/Trainer

There is a vast amount of information available about teaching and learning principles. A selection is provided here to support you in your education of health professionals about subcutaneous infusion devices. Knowles’ theory of adult learning is based on several assumptions:

1. The need to know. Adults need to know why they need to learn something before committing to learn it.
2. The learners’ self-concept. Adults have a self-concept of being responsible for their own lives and decisions, and resent situations where they feel another is imposing their will on them. This can present challenges in adult education. It is important to help the learner be and feel as self-directed as possible.
3. The role of the learners’ experience. Learners come with all their life experience which means that for many kinds of learning, the adult learners themselves already have rich resources for learning. However
   that can produce biases, mental habits and preconceptions that close our minds to fresh perceptions, new ideas and different ways of thinking. “…in any situation in which the participants’ experiences are ignored
   or devalued, adults will perceive this as rejecting not only their experience, but rejecting themselves as persons.”
4. Readiness to learn. Adults are ready to learn the things they need to know and be able to do in order to be effective in real-life situations, such as their work.
5. Orientation to learning. Adults are life-centred, or task-centred or problem-centred in their learning orientation. They are motivated to learn to the extent they perceive the learning will help them solve
   problems or perform tasks in real life. Adults learn new knowledge most effectively when presented in the context of a real life situation.
6. Motivation. The most potent motivators for adults are internal, such as the desire for increased job satisfaction, quality of life, and selfesteem. External motivators such as better job, promotion, higher salary are important but less so. Adults are motivated to keep growing and developing but this may be blocked by negative self-concept, time constraints, and educational programs that violate adult learning
   principles. Adult learners have a rich background of life experiences, both personal and work related. Try to tap into that experience when teaching – for example
   • what experience does the person already have with infusion devices?
   • do they have any concerns about using the devices e.g. a preconception that a subcutaneous infusion will hasten death?
   For these sorts of reasons, start with identifying the beginning level of knowledge of your participants. Adults enjoy the opportunity to apply new knowledge – a practical demonstration accompanied by the chance to actually use the device allows them that opportunity.