Background The increasing need for end of life care in older people meant Biggart Hospital admitting more terminally ill patients and the Ayrshire Hospice managing more complex co-morbidity. To deliver best palliative care, shared learning was needed.
Method Key personnel from both sites met bimonthly over an 18 month period. Challenges were identified and strategy determined, nurses’ learning needs having been evaluated by survey. Senior nursing and medical staff visited the hospice as clinical observers. Palliative care ANP attended Biggart weekly. A bespoke teaching programme was delivered to Biggart with four different sessions provided for nursing staff. Teaching sessions were delivered by hospice speciality doctor to geriatrics trainees. Patients and carers/family were surveyed about their care on completion.
Results Before the teaching programme, 26/30 respondents (87%) wished for further palliative care education. Key concerns included pain and symptom management, and a need for a key point of regular contact for advice. After the programme a second staff survey was conducted. 13/17 respondents were keen for more palliative care education. Their main concerns were pain (10), end of life care (10), advance planning and DNACPR (6), care of relatives (1). Of note, this was not the same group that received education or who replied to the first survey. Programme attendees who gave feedback reported increased awareness of palliative care. Following the training programme, relatives (n=10) felt care in Biggart was ‘always good’ (10/10), pain/symptoms ‘always’ or ‘usually’ well managed (5/10; 5/10 respectively); sufficiently supportive both emotionally (8/10) and spiritually (4/10).
Conclusions Joint working improved relationships, skills and confidence. ANP visits consolidated this new approach. Education programme was valued by attendees albeit numbers were small.
Education programmes need learner and management commitment to support attendance. Pain, spiritual support and care of relatives remain key areas for ongoing education.
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