Dignity and patient-centred care for people with palliative care needs in the acute hospital setting: A systematic review

Background: In common with international health policy, The End of Life Care Strategy for England has highlighted the delivery of high quality palliative care in the acute hospital setting as an area of priority. Aim: The aim of this study was to explore the extent of palliative care need in the acute hospital setting, and to explore agreement between different sources in the identification of patients with palliative care need. Design: A cross-sectional survey of palliative care need was undertaken in two UK acute hospitals. Hospital case notes were examined for evidence of palliative care need according to Gold Standards Framework (GSF) prognostic indicator criteria. Medical and nursing staff were asked to identify patients with palliative care needs. Patients (or consultees) completed assessments of palliative care need. Participants: Of a total in-patient population of 1359, complete datasets were collected for 514 patients/consultees. Results: 36.0% of patients were identified as having palliative care needs according to GSF criteria. Medical staff identified 15.5% of patients as having palliative care needs, and nursing staff 17.4% of patients. Patient self-report data indicated that 83.2% of patients meeting GSF criteria had palliative care needs. Conclusion: The results reveal that according to the GSF prognostic guide, over a third of hospital in-patients meet the criteria for palliative care need. Consensus between medical staff, nursing staff and the GSF was poor regarding the identification of patients with palliative care needs. This has significant implications for patient care, and draws into question the utility of the GSF in the hospital setting.

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The dignified approach to care: a pilot study using the patient dignity question as an intervention to enhance dignity and person-centred care for people with palliative care needs in the acute hospital setting

BMC Palliative Care ◽

10.1186/s12904-015-0013-3 ◽

2015 ◽

Vol 14 (1) ◽

Cited By ~ 15

Author(s):

Bridget Johnston ◽

Jan Pringle ◽

Marion Gaffney ◽

Melanie Narayanasamy ◽

Margaret McGuire ◽

...

Keyword(s):

Palliative Care ◽

Pilot Study ◽

Hospital Setting ◽

Acute Hospital ◽

Care Needs ◽

Palliative Care Needs ◽

Acute Hospital Setting

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The effectiveness of interventions in the prevention and management of aggressive behaviours in patients admitted to an acute hospital setting: a systematic review

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/01938924-200907060-00001 ◽

2009 ◽

Vol 7 (6) ◽

pp. 175-233 ◽

Cited By ~ 2

Author(s):

Kate Kynoch ◽

Chiung-Jung (Jo) Wu ◽

Anne M Chang

Keyword(s):

Systematic Review ◽

Hospital Setting ◽

Acute Hospital ◽

Aggressive Behaviours ◽

Acute Hospital Setting

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The impact of the environment on patient experiences of hospital admissions in palliative care

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2015-000891 ◽

2015 ◽

Vol 8 (4) ◽

pp. 485-492 ◽

Cited By ~ 6

Author(s):

Jackie Robinson ◽

Merryn Gott ◽

Clare Gardiner ◽

Christine Ingleton

Keyword(s):

Palliative Care ◽

Health Professionals ◽

Hospital Admissions ◽

Hospital Setting ◽

Prognostic Indicators ◽

Care Needs ◽

Acute Hospitals ◽

Almost All ◽

The Impact ◽

Palliative Care Needs

ObjectiveTo explore the impact of environment on experiences of hospitalisation from the perspective of patient's with palliative care needs.MethodsA qualitative study design using longitudinal semistructured, face-to-face interviews were used to elicit the views of patients with palliative care needs admitted to hospital in 1 large urban acute hospital in New Zealand. The sample comprised of 14 patients admitted to hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need.ResultsAlmost all participants described a range of factors associated with the environment which impacted negatively on their experiences of hospitalisation. This included challenges with the physical surroundings, the impact on social relationships with other patients, families and health professionals and the influence of the cultural milieu of the hospital setting.ConclusionsEmulating the ‘ideal’ environment for palliative care such as that provided in a hospice setting is an unrealistic goal for acute hospitals. Paying attention to the things that can be changed, such as enabling family to stay and improving the flexibility of the physical environment while improving the social interplay between patients and health professionals, may be a more realistic approach than replicating the hospice environment in order to reduce the burden of hospitalisations for patients with palliative care needs.

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Evaluating the specialist palliative care clinical nurse specialist role in an acute hospital setting: a mixed methods sequential explanatory study

BMC Palliative Care ◽

10.1186/s12904-021-00834-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Michael Connolly ◽

Mary Ryder ◽

Kate Frazer ◽

Eileen Furlong ◽

Teresa Plazo Escribano ◽

...

Keyword(s):

Palliative Care ◽

Phase 1 ◽

Hospital Setting ◽

Acute Hospital ◽

Nurse Specialist ◽

Phase 2 ◽

Specialist Palliative Care ◽

Clinical Nurse ◽

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.

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