How community-based nursing in Scotland can ease the pressure on the NHS

February 5, 2015

Source: Marie Curie Cancer Care

Follow this link for the webpage

Date of publication: February 2015

Publication type: Blog

In a nutshell: This blog from Diana Hekerem comments on the shifting of resources from acute services into the community in order that people can be cared for at home if they have no clinical need to be in hospital. The blog highlights the Marie Curie Nursing Service community-based models of care which have supported patients to spend their final weeks at home in a hospice; facilitated safe and timely discharge and offer general nursing and emotional support.

 

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Exploring the cost of care at the end of life

October 2, 2014

Source: The Nuffield Trust

Follow this link for the full report

Date of publication: September 2014

Publication type: Research report

In a nutshell: This report explores the cost of care at the end of life’ uses anonymised person-level datasets to estimate the costs at the end of life relating to GP contacts, community nursing, local authority-funded social care, hospice and hospital care. The research also explores whether reduced hospital activity and costs at the end of life were likely to be offset by increased care costs in other health and social care settings using the Marie Curie home-based palliative care nursing service. The results suggest that cost savings might be available if community-based support were made more widely available to help people to die in their own homes, where that was their preference.

Length of publication: 31p.

 


Midhurst Macmillan Community Specialist Palliative Care Service: Delivering end-of-life care in the community

August 9, 2013

Source: The King’s Fund

Follow this link to download the full-text report

Date of publication: August 2013

Publication type: Report

In a nutshell: the aim of this report was to establish whether community specialist palliative care services offering home nursing increased rates of death at home (avoiding hospitalisation) compared to other models. The review concluded that the evidence that palliative care home nursing for patients with life-limiting illnesses increased the rate of death at home without compromising symptoms, quality of life or increasing costs was inconclusive. The authors’ conclusions are suitably cautious given the limited evidence available.

Length of publication: 34p.

 


Early admission to community-based palliative care reduces use of emergency departments in the ninety days before death

May 22, 2013

Source: Journal of Palliative Medicine Online Ahead of Print: May 15, 2013

Follow this link for the abstract

Date of publication: May 2013

Publication type: Article

In a nutshell: This study investigates whether early admission to community-based palliative care reduces emergency department admissions in the last 90 days of life for patients with cancer. Using data from death registrations and hospital morbidity for 746 Western Australian adults who had died from cancer, the results suggest that proactive care in the form of timely community-based palliative care services assists in preventing vulnerable people at the end of life from being exposed to the stressful emergency department environment and decreases pressure on EDs.

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.


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

May 7, 2013

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

Follow this link for the full-text article

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

May 7, 2013

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

Follow this link for the full text article

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.

 


A ‘good death’ at home: community nurses helping to make it possible

February 1, 2013

Source: British Journal of Community Nursing, v.18(1),  pp40 – 42

Follow this link for the abstract

Date of publication: January 2013

Publication type: Article

In a nutshell: This article discusses current end of life policies and how the community nurse is central to their implementation. It draws on some recent research which has identified the important steps that enable a community nurse to facilitate a good death and a particular research study which illustrated the unique role of the Community Nurse in providing end of life care in a rural setting, but also the challenges.

Length of publication: 3 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: Internurse