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Nurse-led palliative care clinic: optimising choice for patients
  1. Margaret-Mary Cowan1 and
  2. Claire Cardy2
  1. 1EllenorLions Hospices, Gravesend, UK
  2. 2EllenorLions Hospices, Dartford, UK

Abstract

Clinics at the hospice have been largely medically-led with patients attending on an ad-hoc basis with eligibility restricted to existing patients. This project aimed to set up weekly nurse-led clinics with access to all patients; thus allowing patients to access our service at an earlier stage and enabling a more seamless transition to our Specialist Homecare Team when their condition deteriorates.

The clinic was established by an Advanced Nurse Practitioner with appropriate training using Hatchett's (2008) guidelines and aimed to offer a less threatening option to access palliative care in a clinic environment instead of a home visit. The clinic sees patients at initial referral and for ongoing support and fulfils both the DH (2010) suggestion to offer more choice to patients and widen intake to non-cancer patients as well as advancing nursing practice.

Evaluation was facilitated using a questionnaire completed by patients attending. Data was evaluated and comments collated in themes for analysis by the researcher.

This clinic was evaluated highly by patients with 100% saying appointment length was appropriate and 67% stating that their symptoms were fully assessed. 100% of attendees felt satisfied about being seen by a nurse rather than another healthcare professional.

After 1 year referrals for assessment have steadily increased with one fifth from outside agencies. Presently the service has a caseload of clinic-only patients which is a step towards increasing choice and shows greater access to existing hospice services.

The findings confirm that the clinic is an effective use of time and skills and is well received by patients. It offers another dimension of service for patients and this data reinforces the need to extend and develop this service.

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