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  1. Erandi Wijenayake and
  2. Claire Hookey
  1. Douglas Macmillan Hospice, Stoke on Trent, United Kingdom


    Background Integrating research into daily practice is a challenge. Keeping up-to-date with the latest research and guidelines can help clinicians improve quality and safety of care. Following the Palliative Care Congress in 2012, an 'Improving Care Group' (ICG) was set up at Douglas Macmillan Hospice in Stoke-on-Trent.

    Aims The ICG aims to improve care through utilising evidence based research. It is a multidisciplinary group with medical, nursing, physiotherapy, social work and psychology representatives.

    Methods The group identified several areas for which to examine the evidence base. Task groups were established for:

    • Exercise

    • Holistic Assessment Tools

    • Sex and Sexuality

    • Fan Therapy for Breathlessness

    • Clinical Ethics Committees


    Each task group reported back to the ICG and an action plan was agreed.

    Results Literature review in some areas reinforced existing practice. For example, no evidence of benefit for use of holistic assessment tools within specialist palliative care was identified. However, the ICG identified that within the current holistic assessment, sex and sexuality were not well explored leading to a further task group.

    Examples of changes implemented by the ICG include:

    Training for hospice staff in assessment of needs and concerns around sex and sexuality.

    Development of patient information leaflets on sex and intimacy.

    Increased focus on exercise particularly for day therapy unit patients, including the “Tour of Stoke-on-Trent challenge”.

    A pilot of fan therapy for breathlessness.

    Teaching on management of breathlessness for hospice staff.

    Teaching on clinical ethics for hospice staff and identification of a group interested in becoming a hospice clinical ethics committee.

    Conclusions The Improving Care Group has provided a vehicle for enabling staff from different backgrounds and departments to work together to integrate research into practice, across all areas of the hospice.

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