Anticipatory care planning and integration: A primary care pilot study aimed at reducing unplanned hospitalization

Source: British Journal of General Practice, 2012, 62, (595) (e113-e120)

Date of publication: February 2012

Publication type: Article

In a nutshell: This article reviews a pilot study in Scotland which aimed to provide anticipatory care plans (ACPs) for patients who were at risk of hospital admission. Patients’ wishes in the event of sudden deterioration in their health were recorded.  The pilot achieved statistically significant reductions in unplanned hospitalisation for patients with multiple morbidities and  demonstrates the potential for providing both better care as well as better value for health and social care services.

Length of publication: 8 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Acknowledgement: Embase

A narrative literature review of the evidence regarding the economic impact of avoidable hospitalizations amongst palliative care patients in the UK

Source:  Progress in Palliative Care, 19, (6), p291-298.

Follow this link for abstract.   

 Date of publication:  November 2011

Publication type:  article

In a nutshell:  This article provides a narrative review of evidence relating to the potential economic impact of reducing avoidable admissions among palliative care patients in the UK.  A search for evidence on the economic consequences of avoidable hospital admissions among palliative care patients was conducted, and five studies met the inclusion criteria.  The limited evidence showed that avoidable readmission rates are high. The full economic consequences of reducing readmissions however, has not been addressed.  The authors call for more evidence with a focus on the economic implications for community care versus acute care.

Length of publication:  8 pages

Some important notes:  Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Acknowledgement:  EMBASE

What are patients’ priorities when facing the end of life? A critical review.

Source: International Journal of Palliative Nursing, 2011,17 (6), p.294-300

Follow this link  for fulltext 

Date of publication: June 2011

Publication type: Review, Article

In a nutshell:  The objective of this critical review was to investigate what patients’ priorities are when facing the end of life. A methodical and explicit search was made of academic databases to identify key articles. These articles were then critically appraised and the data was extracted and anylsed using an appropriate methodology. Findings showed that patients wanted:

• to understand and accept their changing health status

• to retain some normality in life

• to be supported by friends and family

• to know they will be taken care of after the death

• good and trusting relationships with health professionals.

Length of publication: 7 pages

Some important notes:

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Acknowledgement: BNI

Nurses’ views on using the Liverpool Care Pathway in an acute hospital setting

Source: International Journal of Palliative Nursing, 2011, 17(5) p.239-44

Follow this link for fulltext.

Date of publication: May 2011

Publication type: Article

In a nutshell: This article describes a piece of qualitative research exploring nurses’ perceptions and experiences of using the Liverpool Care Pathway (LCP) for patients dying in an acute setting. The research examined the experiences of general nurses, and compared them with those of LCP link nurses who have a special interest in palliative and end-of-life care, through the use of focus groups.

Length of publication: 6 pages

Some important notes: An NHS Athens password is required to access this article online. Follow this link to register for Athens.

Acknowledgement: BNI

Dying Matters – GP Pilot Project Evaluation

 Source:  Dying Matters

Follow this link  for the report in  fulltext

Follow this link  for a summary of the report

Date of publication:  October 2010

Publication type:  Report

In a nutshell:  This report by the Dying Matters coalition shows that with the right support Doctors can feel confident discussing death with patients.   In addition the pilot study had a positive effect on patient outcomes and increased the numbers of patients who communicated openly about their needs and preferences at the end of life.  At the outset of the pilot 60% of the participating GPs expressed concern that patients would find discussions about their choices at the end of their lives distressing however 90% of the patients continued the conversation once it has been initiated by their GP.

Length of publication:  50 pages

Social care and hospital use at the end of life

Source:  The Nuffield Trust

Follow this link for fulltext

Date of publication:  December 2010

Publication type:  Report

In a nutshell:  This report shows the finding of research conducted by the Nuffield Trust into the use and estimated costs of hospital and social care services for large groups of individuals at the end of their lives.  Key findings indicate:

• An average of 30 per cent of the people who died used some form of local authority-funded social care service in the 12 months prior to death.
• Local authority-funded social care increased gradually in the last year of life, whereas NHS-funded inpatient hospital care increased sharply.
• The balance of total hospital inpatient and social care costs shifted dramatically with increasing age.

Further research involving a larger population has been commissioned by the National End of Life Care Intelligence Network.

Length of publication:  34 pages

End of life care for community dwelling older people with dementia: an integrated review

Source: International Journal of Geriatric Psychiatry Vol. 25(4) p329-37

Follow link for article abstract

Date: April 2010

Publication type: Article

In a nutshell: Literature review of qualitative and quantitative research into terminal care for people with dementia living in care homes and in the community. The need for recognition that death is approaching, assessment of symptom management needs, difficulties in advance care planning and carer involvement in decision making are discussed.

Length of publication: 9 pages

Some important notes: Contact your local health library for a copy of this article. Follow this link to find your local health library.

Palliative care in dementia: consensus in North Tyneside

Title: Palliative care in dementia: consensus in North Tyneside

Source: European Journal of Palliative Care 2010, 17(2), p92-5

Follow this link for the full article

Date of Publication: March/ April 2010

Publication type: Article

In a nutshell: This article looks at the task of improving palliative care services to patients with dementia in North Tyneside. Areas for improvement by an interdisciplinary team include advance care planning, psychological support, management of acute events and terminal care.

Length of Publication: 4 Pages

Acknowledgement: British Nursing Index (BNI)

Ensuring patient choices about dignity and place of death are respected at the end of life

Title: Ensuring patient choices about dignity and place of death are respected at the end of life

Source: Nursingtimes.net

Follow this link for the full article

Date of publication: June 2010

Publication type: Web article

In a nutshell: This article examines how services must adapt in order that patients’ palliative care preferences are respected. Patient choice and dignity are priorities in providing high quality end of life care.  The article further examines some of the dilemmas nurses may face in respecting patients’ preferences about place of care and death, and looks at how services may need to change in the future to meet the needs of the increasing ageing population.

Justifying terminal care by ‘retrospective quality-adjusted life-years’

Title: Justifying terminal care by ‘retrospective quality-adjusted life-years’

Source: Journal of Medical Ethics 2010(36), p290-292

Follow this link for the abstract

Date of Publication: May 2010

In a nutshell: QALYs are a crude tool used in terms of the number of quality-adjusted life-years a medical procedure will provide, however they cannot justify spending any money on terminal care (and indeed on older people in general). This paper suggests a different way of construing ‘quality’ (as meaningfulness rather than physical comfort) and ‘life’ (as both backward-looking and forward-looking), so that the terminal patient’s efforts to find meaning in his life could in principle generate plenty of ‘retrospective QALYs’ to justify funding.

Length of Publication: 2 pages

Some important notes: This article is available online using an NHS Athens password. To register for an NHS Athens password follow this link, alternatively contact your local health library for a copy of this article.

Consultation on the Palliative and End of Life Care Strategy for adults in Northern Ireland.

Title:  Consultation on the Palliative and End of Life Care Strategy for adults in Northern Ireland.

Source: Northern Ireland Executive Dept of Health, Social Services and Public Safety

Follow this link for the Public Consultation document in full text.

Follow this link for the Consultation Response questionnaire (pdf format).

Date of publication: December 2009

Publication type: News item.

In a nutshell:  The draft 5 year Strategy intends to ensure that everyone, from diagnosis to the advanced noncurative stage of disease, lives and dies well irrespective of their condition or care setting. It provides a vision and direction for service planning and delivery and considers current and predicted demographics, available intelligence and the results of existing consultation which have informed the implementation of other policy areas, Service Frameworks, and Priorities for Action Targets.  It also takes into account policy context from the wider UK and the Republic of Ireland.  Views are sought from all stakeholders by the deadline of 19.02.10.

Length of publication: The Public Consultation document is 95 pages, the Consultation Response questionnaire is 13 pages.

Acknowledgement: Omega, The National Association for End of Life Care

RCGP Launches Groundbreaking ‘Ante-Mortem’ End of Life Care Strategy

Source: Royal College of General Practitioners.

Follow this link  for fulltext of the press release.

Follow this link to the webpage about the strategy and to link to the strategy in full.

Date of publication: November 2009  

Publication type: Press release. 

 In a nutshell:  The Royal College of General Practitioners (RCGP) has published a new national strategy with the objective of improving the standards of end of life care.  The strategy identifies 10 recommended areas for further work, including:

• Reviewing and refinement of existing educational resources
• Endorsing the use of Advance Care Planning
• Improving Out of Hours Palliative Care
• Strengthening team-working with nurses, as part of the primary healthcare team

The overall objective of the strategy is to fundamentally improve standards of care for those in the last stages of life. 

 

How improving services can hold the key to end of life care choices

Source:  Journal of Care Services Management  Volume 4, Number 1 / October–December, 2009

Date of publication: September 2009

Publication type: Article

In a nutshell: The Marie Curie Delivering Choice programme has been implemented in various UK locations and has shown that the high numbers of hospital deaths in the UK can be reduced if services become more efficient, responsive and provide holistic quality care. The programme advocates a whole systems approach to redesign services with the objective of providing choice for terminally ill patients about where they want to receive care until they die. Key findings are that services both in hospital and community settings need to improve.

Length of publication: 8 pages

Some important notes:  Please contact your local NHS Library for the full text of the article.  Follow this link to find your local NHS Library.

New community nursing role for end-of-life care

Author: Steve Ford

Source: NursingTimes.net

In a nutshell: A new type of community nursing role is due to be rolled out in east Yorkshire from this week. The new role, called a ‘Health and Social Care Assistant’, is to be introduced in Hull to nurse end-of-life care patients in their own homes. There will initially be nine HSCAs with more to follow. There is enough funding for 12 full time equivalents.

Click here for full article