The Integrated Palliative Care Outcome Scale for Patients with Palliative Care Needs: Factors Related to and Experiences of the Use in Acute Care Settings

2019 ◽  
Author(s):  
Susanne Lind
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Care Needs ◽  
Palliative Care Outcome Scale ◽  
Acute Care Settings ◽  
Palliative Care Needs ◽  
Care Outcome

The integrated palliative care outcome scale for patients with palliative care needs: Factors related to and experiences of the use in acute care settings

2019 ◽  
Vol 17 (5) ◽  
pp. 561-568 ◽  
Author(s):  
Susanne Lind ◽  
Lars Wallin ◽  
Carl Johan Fürst ◽  
Ingela Beck
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Healthcare Professionals ◽  
Assessment Tools ◽  
Successful Implementation ◽  
Care Needs ◽  
Palliative Care Outcome Scale ◽  
Acute Care Settings ◽  
Palliative Care Needs ◽  
Care Outcome

AbstractObjectiveImplementation of patient-reported outcome measures for patients with palliative care needs is characterized by both enablers and barriers. The ways in which healthcare professionals experience the use of assessment tools is important. Our aims were to explore factors contributing to or hindering patients with palliative care needs in assessing their symptoms with the Integrated Palliative Care Outcome Scale (IPOS) and to explore healthcare professionals’ experiences of the use of IPOS in acute care settings.MethodData were collected as a part of the evaluation of the feasibility of an implementation strategy for introducing IPOS. Data from three participating acute care units were included. We used descriptive and analytical statistics; a qualitative content analysis was also performed.ResultA total of 309 patients were eligible to be offered assessment of symptoms with IPOS. Of these 69 (22%) had completed IPOS. A significant positive association was found between healthcare professionals’ participation in training sessions and completed IPOS. The experiences of IPOS were split into two categories: “IPOS acting as a facilitator” and “barriers to the use of IPOS.” The use of IPOS was described as contributing to person-centered care of patients with palliative care needs and inspiration to improved routines. Healthcare professionals’ feelings of uncertainty about how to approach severely ill patients and their family members appear to have hindered their use of IPOS.Significance of resultsWe found an association between healthcare professionals’ participation in training sessions and patients who completed IPOS, indicating the need for a high degree of attendance at the training to achieve successful implementation. The healthcare professionals expressed feelings of insecurity concerning the use of IPOS indicating a need for further education and clinical support in its use of IPOS. Nevertheless, use of IPOS was considered to contribute to improved care of patients with palliative care needs.

Implementation of the integrated palliative care outcome scale in acute care settings – a feasibility study

2018 ◽  
Vol 16 (6) ◽  
pp. 698-705 ◽  
Author(s):  
Susanne Lind ◽  
J. Sandberg ◽  
T. Brytting ◽  
C.J. Fürst ◽  
L. Wallin
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Patient Reported Outcome Measures ◽  
Palliative Care Unit ◽  
Positive Effects ◽  
Palliative Care Outcome Scale ◽  
Patient Reported ◽  
Acute Care Settings ◽  
The Impact ◽  
Care Outcome

AbstractObjectiveAlthough hospitals have been described as inadequate place for end-of-life care, many deaths still occur in hospital settings. Although patient-reported outcome measures have shown positive effects for patients in need of palliative care, little is known about how to implement them. We aimed to explore the feasibility of a pilot version of an implementation strategy for the Integrated Palliative care Outcome Scale (IPOS) in acute care settings.MethodA strategy, including information, training, and facilitation to support the use of IPOS, was developed and carried out at three acute care units. For an even broader understanding of the strategy, it was also tested at a palliative care unit. A process evaluation was conducted including collecting quantitative data and performing interviews with healthcare professionals.ResultFactors related to the design and performance of the strategy and the context contributed to the results. The prevalence of completed IPOS in the patient's records varied from 6% to 44% in the acute care settings. At the palliative care unit, the prevalence in the inpatient unit was 53% and the specialized home care team 35%. The qualitative results showed opposing perspectives concerning the training provided: Related to everyday work at the acute care units and Nothing in it for us at the palliative care unit. In the acute care settings, A need for an improved culture regarding palliative care was identified. A context characterized by A constantly increasing workload, a feeling of Constantly on-going changes, and a feeling of Change fatigue were found at all units. Furthermore, the internal facilitators and the nurse managers’ involvement in the implementation differed between the units.Significance of the resultsThe feasibility of the strategy in our study is considered to be questionable and the components need to be further explored to enhance the impact of the strategy and thereby improve the use of IPOS.

Meeting Palliative Care Needs in Post–Acute Care Settings

JAMA ◽  
2006 ◽  
Vol 295 (6) ◽  
pp. 681 ◽  
Author(s):  
Laura C. Hanson ◽  
Mary Ersek
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Care Needs ◽  
Acute Care Settings ◽  
Palliative Care Needs ◽  
Post Acute Care

Utility of the integrated palliative care outcome scale (IPOS): a cross-sectional study in hospitalised patients with heart failure

2020 ◽  
pp. 147451512091938 ◽  
Author(s):  
Carmen Roch ◽  
Johanna Palzer ◽  
Teresa Zetzl ◽  
Stefan Störk ◽  
Stefan Frantz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Cross Sectional Study ◽  
Emotional Symptoms ◽  
Care Needs ◽  
Cross Sectional ◽  
Palliative Care Outcome Scale ◽  
Hospitalised Patients ◽  
Patients With Heart Failure ◽  
Care Outcome

Aim The aim of this study was to evaluate the suitability and comprehensibility of the integrated palliative care outcome scale for the evaluation of palliative care needs in patients with heart failure. Methods and results This cross-sectional study investigated 100 heart failure patients (40 women, 60 men; median age 79 years) within the first few days of their hospitalisation by applying the integrated palliative care outcome scale (3-day recall period) and two additional self-developed questions about the suitability and comprehensibility of the integrated palliative care outcome scale. Clinically relevant somatic and psycho-emotional symptoms were reported very frequently (approximately 75% each), followed by communicational needs or practical issues. Ninety-five per cent of patients thought the integrated palliative care outcome scale very easy to understand, and 91% judged the integrated palliative care outcome scale suitable to assess palliative care needs. Conclusion The integrated palliative care outcome scale was well accepted by hospitalised patients with heart failure and identified a high burden of both physical and psycho-emotional symptoms. Screening for palliative care has to consider patients and their relatives alike, and should be part of a comprehensive care concept jointly integrated into clinical routine by primary and specialised palliative care teams.

Healthcare providers’ views and experiences of non-specialist palliative care in hospitals: A qualitative systematic review and thematic synthesis

2020 ◽  
Vol 34 (5) ◽  
pp. 605-618 ◽  
Author(s):  
Mary Nevin ◽  
Geralyn Hynes ◽  
Valerie Smith
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Acute Care ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Thematic Synthesis ◽  
Qualitative Systematic Review ◽  
Palliative Care Needs

Background: Healthcare providers working in hospitals are frequently exposed to patients with palliative care needs. For most patients, these reflect non-specialist rather than specialist palliative care needs. Embedding palliative care principles early in patients’ disease trajectories within acute care delivery in hospitals, however, is a challenge. How to best understand the experiences of those providing non-specialist palliative care in hospitals has not been systematically assessed. Aim: To synthesise the evidence on healthcare providers’ views and experiences of non-specialist palliative care in hospitals. Design: A qualitative systematic review and thematic synthesis using Thomas and Harden’s thematic synthesis framework. Data sources: Databases of MEDLINE, CINAHL, PsycINFO and EMBASE were searched from date of inception to March 2018. Studies were eligible for inclusion if they reported on healthcare providers’ views and experiences of non-specialist palliative care in hospitals. Studies were appraised for quality but not excluded on that basis. The review was prospectively registered with the International Prospective Register of Systematic Reviews. Results: Thirty-nine papers of 37 studies were included, representing 985 hospital healthcare providers’ views and experiences. Four major analytical themes emerged; ‘Understanding of Palliative Care’, ‘Complexities of Communication’, ‘Hospital Ecosystem’ and ‘Doctors and Nurses – a Different Lens’. Conclusions: Non-specialist palliative care in hospitals is operationalised as care in the last weeks and days of life. The organisation of acute care, inter-disciplinary working practices, clinician attitudes, poor communication structures and lack of education and training in palliative care principles exacerbates poor implementation of this care earlier for patients in hospitals.

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