Healthcare Providers' Views and Experiences of Non-specialist Palliative Care (NSPC) in the Acute Care Hospital Setting: A Systematic Review

2019 ◽  
Author(s):  
Mary Nevin
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Acute Care ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Specialist Palliative Care

Antibiotic Use in the Last Week of Life in Three Different Palliative Care Settings

2002 ◽  
Vol 18 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Doreen Oneschuk ◽  
Robin Fainsinger ◽  
Donna Demoissac
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Antibiotic Use ◽  
Palliative Care Unit ◽  
Antibiotic Administration ◽  
Care Hospital ◽  
Marked Variability ◽  
Number Of Patients

The purpose of this study was to examine the frequency and types of antibiotics prescribed in the last week of life in three different palliative care settings, including an acute care hospital, tertiary palliative care unit, and three hospice units. A total of 150 consecutive patients were evaluated, 50 in each of the three settings. Twenty-nine patients (58%) in the acute hospital setting, 26 (52%) in the tertiary palliative care unit, and 11(22%) in the hospice settings were prescribed antibiotics. In the acute care and tertiary palliative care settings, the most frequent route of antibiotic administration was intravenous and, in the hospice setting, oral. We conclude that there is marked variability in the numbers and types of antibiotics prescribed in these different palliative care settings in the last week of life. The high use of intravenous antibiotics and the large number of patients who were still receiving antibiotics at the time of death indicate the need for further prospective studies.

scholarly journals Recommendations for incorporating palliative care education into the acute care hospital setting

1999 ◽  
Vol 74 (8) ◽  
pp. 871-7 ◽  
Author(s):  
D E Weissman ◽  
S D Block ◽  
L Blank ◽  
J Cain ◽  
N Cassem ◽  
...  
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Care Education ◽  
Palliative Care Education

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.

Fall Prevention in a Swiss Acute Care Hospital Setting: Reducing Multiple Falls

2006 ◽  
Vol 32 (3) ◽  
pp. 13-22 ◽  
Author(s):  
Koen Milisen ◽  
Courtney W. Brown ◽  
Sabina De Geest
Keyword(s):  
Acute Care ◽  
Fall Prevention ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Care Hospital

Palliative care transitions from acute care to community-based care: A qualitative systematic review of the experiences and perspectives of health care providers

2020 ◽  
Vol 34 (10) ◽  
pp. 1316-1331 ◽  
Author(s):  
Tieghan Killackey ◽  
Emily Lovrics ◽  
Stephanie Saunders ◽  
Sarina R. Isenberg
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Acute Care ◽  
Health Care Providers ◽  
Thematic Analysis ◽  
Healthcare Providers ◽  
Discharge Process ◽  
Care Providers ◽  
Community Based ◽  
Qualitative Systematic Review

Background: Transitioning from the hospital to community is a vulnerable point in patients’ care trajectory, yet little is known about this experience within the context of palliative care. While some studies have examined the patient and caregiver experience, no study to date has synthesized the literature on the healthcare provider’s perspective on their role and experience facilitating these transitions. Aim: The purpose of this systematic review was to understand the experience and perspective of healthcare providers who support the transition of patients receiving palliative care as they move from acute care to community settings. Design: A qualitative systematic review of studies using thematic analysis as outlined by Thomas and Harden. PROSPERO: ID # CRD42018109662. Data Sources: We searched four databases: MEDLINE, Embase, ProQuest and CINAHL for studies published in English from 1995 until May 22, 2020. Four reviewers screened records using the following selection criteria: (1) peer-reviewed empirical study, (2) adult sample, (3) qualitative study design, (4) perspective of healthcare providers, and (5) included a component of transitions between acute to community-based palliative care. Study findings were analyzed using thematic analysis which entailed: (1) grouping the findings into recurring themes; (2) iteratively referring back to the articles to obtain nuances of the theme and quotations; and (3) defining and solidifying the themes. Results: Overall 1,791 studies were identified and 15 met inclusion criteria. Studies were published recently (>2015, n = 12, 80%) and used a range of qualitative methods including semi-structured interviews, focus groups, and field interviews. Three core themes related to the role and experience of healthcare providers were identified: (1) assessing and preparing for transition; (2) organizing and facilitating the logistics of transition; and (3) coordinating and collaborating transitional care across sectors. The majority of studies focused on the discharge process from acute care; there was a lack of studies exploring the experiences of healthcare providers in the community who receive patients from acute care and provide them with palliative care at home. Conclusion: This review identified studies from a range of relatively high-income countries that included a diverse sample of healthcare providers. The results indicate that healthcare providers experience multiple complex roles during the transition facilitation process, and future research should examine how to better assist clinicians in supporting these transitions within the context of palliative care provision.

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