{"id":29866,"date":"2017-12-22T10:34:49","date_gmt":"2017-12-22T09:34:49","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=29866"},"modified":"2017-12-22T10:34:49","modified_gmt":"2017-12-22T09:34:49","slug":"sance-pro-nevylecitelne-nemocne-deti","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=29866","title":{"rendered":"\u0160ance pro nevyl\u00e9\u010diteln\u011b nemocn\u00e9 d\u011bti"},"content":{"rendered":"<p><strong>\u00da\u010dastn\u00edci panelov\u00e9 diskuse 1. 12. 2017 na konferenci d\u011btsk\u00e9 paliativn\u00ed p\u00e9\u010de v Olomouci kladli d\u016fraz na zlep\u0161en\u00ed komunikace ve spole\u010dnosti a mezi odborn\u00edky r\u016fzn\u00fdch zdravotnick\u00fdch, o\u0161et\u0159ova-telsk\u00fdch profes\u00ed, proto\u017ee paliativn\u00ed p\u00e9\u010di lze dob\u0159e poskytovat jak ve zdravotnick\u00fdch za\u0159\u00edzen\u00ed, tak i v dom\u00e1c\u00edm prost\u0159ed\u00ed.<\/strong><!--more--><\/p>\n<p>Jak zd\u016fraznil MUDr. Jan Hr\u030ci\u0301del, Ph.D., z Kliniky d\u011btsk\u00e9ho a dorostov\u00e9ho l\u00e9ka\u0159stv\u00ed\u0301 1. LF UK a VFN v Praze, nezbytn\u00fdm p\u0159edpokladem pro zlep\u0161en\u00ed sou\u010dasn\u00e9ho stavu je prosa-zen\u00ed v\u00fduky paliativn\u00ed p\u00e9\u010de do pregradu\u00e1ln\u00edho i postgradu\u00e1ln\u00edho vzd\u011bl\u00e1v\u00e1n\u00ed l\u00e9ka\u0159\u016f a dal-\u0161\u00edch profes\u00ed, kter\u00e9 se na p\u00e9\u010di o d\u011bti s nep\u0159\u00edznivou progn\u00f3zou pod\u00edlej\u00ed. \u201eAktu\u00e1ln\u011b se n\u00e1m poda\u0159ilo prosadit n\u011bkolik hodin v\u00fduky paliativn\u00ed p\u00e9\u010de do povinn\u00e9ho kurzu p\u0159ed z\u00e1kladn\u00edm kmenem vzd\u011bl\u00e1vac\u00edho programu pediatrie, co\u017e pova\u017euji za velik\u00fd \u00fasp\u011bch. Absolventi l\u00e9ka\u0159-sk\u00fdch fakult jsou velmi dob\u0159e p\u0159ipraveni l\u00e9\u010dit, ale o tom, co prov\u00e1z\u00ed um\u00edr\u00e1n\u00ed d\u011bt\u00ed, se tak dozv\u011bd\u00ed velmi pravd\u011bpodobn\u011b poprv\u00e9,\u201c p\u0159ipomn\u011bla MUDr. Mahulena Mojz\u030ci\u0301s\u030cova\u0301, pr\u030ced-sedkyne\u030c Sekce d\u011btsk\u00e9\u0301 paliativn\u00ed\u0301 p\u00e9\u010de C\u030cSPM C\u030cLS JEP, prim\u00e1\u0159ka d\u011btsk\u00e9ho odd\u011bleni\u0301 Nemocnice Ho\u0159ovice.<\/p>\n<p>Z\u00e1kladem rozvoje d\u011btsk\u00e9 paliativn\u00ed p\u00e9\u010de v nemocnic\u00edch je mimo jin\u00e9 nalezen\u00ed zp\u016fsobu jej\u00edho financov\u00e1n\u00ed. Mgr. Ji\u0159\u00ed Krej\u010di\u0301, mana\u017eer Sekce d\u011btsk\u00e9\u0301 paliativn\u00ed\u0301 p\u00e9\u010de C\u030cSPM C\u030cLS JEP, v t\u00e9to souvislosti p\u0159ipomn\u011bl, \u017ee ministerstvo zdravotnictv\u00ed v minul\u00e9m volebn\u00edm ob-dob\u00ed rozhodlo o t\u0159\u00edlet\u00e9m pilotn\u00edm projektu, b\u011bhem n\u011bho\u017e chce ov\u011b\u0159it, jak by mohly palia-tivn\u00ed t\u00fdmy v nemocnic\u00edch fungovat, jak by m\u011bla b\u00fdt jejich \u010dinnost standardizov\u00e1na a jak\u00fd vy\u010d\u00edsliteln\u00fd benefit zdravotn\u00edmu syst\u00e9mu i pacient\u016fm by p\u0159inesla. Jedn\u00edm z optim\u00e1ln\u00edch v\u00fdstup\u016f tohoto pilotn\u00edho projektu by m\u011bl b\u00fdt model \u00fahrady nemocni\u010dn\u00ed paliativn\u00ed p\u00e9\u010de. \u201eLze opr\u00e1vn\u011bn\u011b o\u010dek\u00e1vat, \u017ee se dopl\u0148ov\u00e1n\u00ed, resp. nahrazov\u00e1n\u00ed intenzivn\u00edho p\u0159\u00edstupu palia-tivn\u00ed p\u00e9\u010d\u00ed nakonec uk\u00e1\u017ee b\u00fdt racion\u00e1ln\u011bj\u0161\u00ed v alokaci zdroj\u016f a v kone\u010dn\u00e9m d\u016fsledku tak i lev-n\u011bj\u0161\u00ed,\u201c p\u0159ipomn\u011bl MUDr. Jan H\u0159\u00eddel.<\/p>\n<p>MUDr. Katalin S\u030cte\u030crbova\u0301 z Kliniky d\u011btsk\u00e9\u0301 neurologie 2. LF UK a FN Motol pouk\u00e1zala na nedostate\u010dn\u011b funk\u010dn\u00ed spolupr\u00e1ci mezi klinickou a ambulantn\u00ed sf\u00e9rou. \u201cExistence ne-mocni\u010dn\u00edch paliativn\u00edch t\u00fdm\u016f je jedna v\u011bc, ale pokud nebude komu p\u0159ed\u00e1vat takov\u00e9 paci-enty do dom\u00e1c\u00ed p\u00e9\u010de, pozb\u00fdv\u00e1 cel\u00e9 sna\u017een\u00ed smysl.\u201d \u00da\u010dastn\u00edci panelov\u00e9 diskuse se shodli v tom, \u017ee p\u0159irozen\u00fdm centrem, kolem kter\u00e9ho by se m\u011bla paliativn\u00ed p\u00e9\u010de o d\u011btsk\u00e9ho paci-enta v dom\u00e1c\u00edm prost\u0159ed\u00ed soust\u0159edit, je registruj\u00edc\u00ed praktick\u00fd l\u00e9ka\u0159 pro d\u011bti a dorost. \u201eNe-mocnice informuje registruj\u00edc\u00edho praktick\u00e9ho l\u00e9ka\u0159e o p\u0159ipravovan\u00e9m propu\u0161t\u011bn\u00ed d\u00edt\u011bte do dom\u00e1c\u00edho o\u0161et\u0159ov\u00e1n\u00ed. O\u0161et\u0159uj\u00edc\u00ed praktick\u00fd l\u00e9ka\u0159 nab\u00eddne co je v dan\u00e9 lokalit\u011b mo\u017en\u00e9 zajistit (nap\u0159. spolupr\u00e1ci s agenturami dom\u00e1c\u00ed p\u00e9\u010de, psychologickou poradnu apod.). Mobiln\u00ed hos-pice by m\u011bly b\u00fdt prim\u00e1rn\u011b ur\u010den\u00e9 pro nemocn\u00e9 s klinicky nestabiln\u00edm onemocn\u011bn\u00edm \u010di se z\u00e1va\u017enou symptomatologi\u00ed, kter\u00e1 je nad mo\u017enost\u00ed poskytov\u00e1n\u00ed dom\u00e1c\u00ed p\u00e9\u010de. Rozhodn\u011b by-chom se v \u010cR nem\u011bli \u0161t\u011bpit na des\u00edtky r\u016fzn\u00fdch model\u016f dle jednotliv\u00fdch poskytovatel\u016f, ale m\u011bli bychom hledat pr\u016fse\u010d\u00edky v tom, co n\u00e1s spojuje,\u201c vyj\u00e1d\u0159il sv\u00e9 p\u0159esv\u011bd\u010den\u00ed Pavel Kli-me\u0161, vrchn\u00ed sestra mobiln\u00edho hospice Cesta dom\u016f.<\/p>\n<p>MUDr. Alena \u0160ebkov\u00e1, p\u0159edsedkyn\u011b Odborn\u00e9 spole\u010dnosti praktick\u00fdch d\u011btsk\u00fdch l\u00e9-ka\u0159\u016f \u010cLS JEP k tomu ve sv\u00e9m dopise adresovan\u00e9m \u00fa\u010dastn\u00edk\u016fm panelov\u00e9 diskuze dod\u00e1v\u00e1, \u017ee d\u011bt\u0161t\u00ed prakti\u010dt\u00ed l\u00e9ka\u0159i uv\u00edtaj\u00ed \u00fa\u010dast v kultivaci syst\u00e9mu poskytov\u00e1n\u00ed paliativn\u00ed p\u00e9\u010de d\u011b-tem v dom\u00e1c\u00edm prost\u0159ed\u00ed, kter\u00e9 je ostatn\u011b pro pr\u00e1ci l\u00e9ka\u0159\u016f v prim\u00e1rn\u00ed p\u00e9\u010di charakteris-tick\u00e9. \u201eUv\u00edtali bychom v tomto syst\u00e9mu existenci paliativn\u00edch t\u00fdm\u016f v regionech, do kter\u00fdch by aktu\u00e1ln\u011b mohli p\u0159istupovat prakti\u010dt\u00ed l\u00e9ka\u0159i pro d\u011bti a dorost. V paliativn\u00ed d\u011btsk\u00e9 p\u00e9\u010di vi-d\u00edme jedno ze z\u00e1va\u017en\u00fdch t\u00e9mat sou\u010dasnosti a klasickou uk\u00e1zku nutn\u00e9 mezioborov\u00e9 i mezi-rezortn\u00ed spolupr\u00e1ce.\u201c \u00da\u010dastn\u00edci panelov\u00e9 diskuze se d\u00e1le shodli, \u017ee pro zaji\u0161t\u011bn\u00ed d\u011bt-sk\u00e9 paliativn\u00ed p\u00e9\u010de v \u010cR nen\u00ed pot\u0159eba m\u011bnit z\u00e1kony, ale pouze spr\u00e1vn\u011b vyu\u017e\u00edt platn\u00fd legislativn\u00ed r\u00e1mec. Od ledna 2018 je v \u00fahradov\u00e9 vyhl\u00e1\u0161ce nov\u011b agregovan\u00fd v\u00fdkon, pod kter\u00fdm lze \u017e\u00e1dat zdravotn\u00ed poji\u0161\u0165ovny o \u00fahradu mobiln\u00ed specializovan\u00e9 paliativn\u00ed p\u00e9\u010de. \u201eZaveden\u00edm \u00fahrady mobiln\u00ed specializovan\u00e9 p\u00e9\u010de z prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161-t\u011bn\u00ed se nijak nezv\u00fd\u0161\u00ed v\u00fddaje na poskytovanou zdravotn\u00ed p\u00e9\u010di v syst\u00e9mu. Umo\u017en\u00edme t\u00edm ale zaji\u0161t\u011bn\u00ed stejn\u011b kvalitn\u00ed p\u00e9\u010de o d\u00edt\u011b v dom\u00e1c\u00edm prost\u0159ed\u00ed bez toho, aby str\u00e1vilo posledn\u00ed m\u011b-s\u00edce sv\u00e9ho \u017eivota na odd\u011blen\u00ed ARO, a t\u00edm zv\u00fd\u0161\u00edme kvalitu \u017eivota nejen d\u00edt\u011bti samotn\u00e9mu, ale i v\u0161em pe\u010duj\u00edc\u00edm\u201c je p\u0159esv\u011bd\u010den MUDr. Jan H\u0159\u00eddel.<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u00da\u010dastn\u00edci panelov\u00e9 diskuse 1. 12. 2017 na konferenci d\u011btsk\u00e9 paliativn\u00ed p\u00e9\u010de v Olomouci kladli d\u016fraz na zlep\u0161en\u00ed komunikace ve spole\u010dnosti a mezi odborn\u00edky r\u016fzn\u00fdch zdravotnick\u00fdch, <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=29866\" title=\"\u0160ance pro nevyl\u00e9\u010diteln\u011b nemocn\u00e9 d\u011bti\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14373,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-29866","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29866","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29866"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29866\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14373"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29866"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29866"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29866"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}