Introduction Achieving good palliative care in all areas is a goal for palliative care. During 2019-20, in West Essex, there was an increase of 8% admissions to hospital from the nursing homes (NH). 42% of those patients were identified as end of life care (EOLC) patients. Many of these patients were not known to the hospice team. The aim of this new project was to improve access of NH residents to hospice and support for the NH staff to manage palliative and end of life care patients.
Methods The NH project involved:
Regular monthly contacts and networking with nursing home staff and managers.
Direct clinical care of the identified nursing home residents.
Bed-side teaching with nursing home staff on assessment, management and communication for end of life care patients.
Face-to-face teaching and training sessions for nursing home staff on end of life care.
Evaluation was completed by feedback forms and audit of activities.
Analysis 16 nursing homes were identified for contact. After 18 months, a total of 15 nursing homes of the West Essex area participated in this project. From August 2020 to March 2022, 120 patients were referred to hospice from those nursing homes. 116 (96%) of those patients died at the nursing home, one patient died in the hospice and three patients died in the hospital. Four teaching sessions were organised on ‘Recognising and care of dying’ and 50 nursing home staff participated in those teaching sessions. Completion of Proactive Enhanced Advance Care Escalation plan (PEACE) for nursing home residents was put into practice. 31% of referred patients had PEACE document completed.
Conclusion Improved access to specialist palliative care services for the nursing home residents leads to increased nursing home deaths and decreased hospital admissions. Regular contact, networking and partnership working with care home colleagues were factors to improve care and access to the service provision. Nursing home staff developed their knowledge and skills to look after palliative and end of life care patients.
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