Connecting the Dots Between Theoretical Knowledge and Clinical Practice: A Palliative Care Social Worker Process Improvement Project in an Acute Hospital Setting
Abstract
Background
Special palliative care is provided in a range of settings including a patient’s home (their primary place of dwelling), a hospice in-patient unit, or an acute hospital. The aim of the study was to evaluate the role of the specialist in palliative care clinical nurse specialist (SPC CNS) role in an acute hospital setting.
Methods
This study was conducted using a mixed methods sequential explanatory approach in two phases; phase 1 involved completion of a study questionnaire (n = 121) and phase 2 involved part-taking in a focus group (n = 6) or individual interview (n = 4).
Results
Phase 1 results indicated that respondents held positive attitudes towards the Specialist Palliative Care Clinical Nurses Specialist (SPC CNS) in relation to clinical care, education and patient advocacy. Phase 2 qualitative findings identified the importance of the role in terms of symptom management, education and support.
Conclusions
This study provides an evaluation of a SPC CNS role since it was established in an acute hospital setting. The evidence indicates that there is a varied understanding of the role of the SPC CNS. The role was seen as an important one particularly in terms of referrals to and support provided by the SPC CNS, as well as recognition of the importance of the role is providing ongoing education to staff.
This chapter covers the need for hospital liaison palliative care services, challenges in an acute hospital setting, aims and evaluation of the hospital specialist palliative care team, things to think about when considering a referral, urgent discharge of a dying patient who wants to die at home, dying in the intensive care unit (ICU), and using the Liverpool Care Pathway (LCP) in the hospital setting.
Evaluating the specialist palliative care clinical nurse specialist role in an acute hospital setting: a mixed methods sequential explanatory study