End of Life Care Horizon Scanning Bulletin Volume 5 Issue 5

An evaluation of the activity of a 7-day, nurse-led specialist palliative care service in an acute district general hospital.

Source: International Journal of Palliative Nursing, 2013 v.19 (3): 148-51

Follow this link for the full-text article

Date of publication: March 2013

Publication type: Article

In a nutshell: This report describes the activity of a new 7-day-per-week, nurse-led palliative care service in an acute district general hospital in the UK.  The service is based in a hospital with an integral cancer centre. On the weekends, one clinical nurse specialist (CNS) is present within the hospital, with a consultant providing telephone support.The data for this report was obtained by reviewing the team’s clinical database and the patients’ individual clinical assessments. During the first year, the CNSs undertook 651 face-to-face weekend consultations. Overall, 25% of the total consultations and 18% of new patient consultations were undertaken on the weekends. The primary reasons for reviewing patients on the weekends were pain (46%), other symptoms (27.5%), and patient on the Liverpool Care Pathway (17%). Overall, 23% of new patients died over the weekend or in the early hours of the Monday morning. The article concludes that this service evaluation provides evidence of the value of having a 7-day-per-week palliative care service in an acute district general hospital.

Length of publication:  4 pages

Some important notes: This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library.

 

Transitions between care settings after enrolment in a palliative care service in Italy: a retrospective analysis.

Source: International Journal of Palliative Nursing 2013 v.19(3), p110-5

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Date of publication: March 2013

Publication type: Article

In a nutshell: This study was a retrospective analysis of prospectively collected data that aimed to map patients’ care transitions following admission to a specialist palliative care service in Italy called Antea Centre. External transitions were defined as a change in the setting of care, with the patient no longer being cared for by Antea staff. Internal transitions were defined as a change in the setting of care, with the care still being provided by Antea staff. A total of I 123 patients out of 5313 admitted to the palliative service (21%) experienced transitions. Patients who experienced no transitions after their admission to the palliative care service were more likely to have a Karnofsky Performance Scale Index ≤30, to have been referred by a hospital physician, to have a shorter survival time, and to have home as their place of death (P<0.001). The article concluded that, although the patients with no transitions had worse clinical conditions, organisations should pay attention to reducing the possible negative effects of transitions, such as discontinuity of care and poor coordination.

Length of publication: 6 pages

Some important notes: This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library

 

Facilitating advance care planning in community palliative care: conversation starters across the client journey

Source: International Journal of Palliative Nursing 2013 19(3) p.132-9

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Date of publication: March 2013

Publication type: Article

In a nutshell: This paper describes the development of a tool for palliative care nurses to initiate and facilitate advance care planning (ACP) conversations in community palliative care practice. Seven community palliative care services located across Australia participated in a multi-site action research project. Data included participant observation, individual and focus group interviews with palliative care health professionals, and medical record audit. A directed content analysis used a pre-established palliative care practice framework of referral, admission, ongoing management, and terminal/discharge care. From this framework a Conversation Starter Tool for ACP was developed.The Tool was then used in orientation and continuing nurse education programmes. It provided palliative care nurses the opportunity to introduce and progress ACP conversations.

Length of publication: 8 pages

Some important notes: This article is available in full text to all NHS Staff using Athens, for more information about accessing full text follow this link to find your local NHS Library.

 

National End of Life Care Intelligence Network – End of Life Care Profiles

Source: AQuA

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Date of publication: April 2013

Publication type: Website

In a nutshell: AQuA  has published End of Life Care Local Authority Profiles 2012 , which present over 50 indicators for each local authority in England. They include social care indicators for the first time. Also available are the End of Life Care Primary Care Trust (PCT) Profiles which present over 40 indicators.

NICE support for commissioners of dementia care

Source: NICE

Follow this link for the guidance

Date of publication: April 2013

Publication type: Guidelines

In a nutshell: The National Institute for Health and Care Excellence (NICE) has issued a guide to support the commissioning of high-quality, evidence-based care of people who have dementia. The NICE support for commissioning dementia care provides practical advice for commissioners to improve the integration of health and social care. This will help ensure that more people with dementia receive an early diagnosis and can access the care and support that they, and their carers, need to live well and independently with dementia for as long as possible. Support for commissioning will help commissioners achieve the outcomes set out in the clinical commissioning group outcomes indicator set and other national health and social care outcomes frameworks. The commissioning tool that accompanies this guide enables commissioners to show how well they are performing against a range of outcome measures that together demonstrate how well the whole system is working.

A six-step guide to commissioning end of life care

Source: Royal College of General Practitioners

Follow this link for to download the guidance

Date of publication: March 2013

Publication type: Report

In a nutshell: RCGP Commissioning Guidance in End of Life Care provides GPs and clinical commissioning groups (CCGs) with a logical, six-step framework and overview to support their work in delivering practical improvements across the health, social care and voluntary and independent sectors. The guidance has been produced to ensure that the needs of dying patients and those closest to them are paramount whilst services are commissioned and developed around them.

Length of publication: 56p.

Acknowledgement: Commissioning Zone – NHS Networks